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

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.

Percentage of ANA nurses who "worry" about medication errors (2007 survey).

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

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.

Millions of people around the globe have received chiropractic care and know its value. But the rest of the population dismisses the profession’s growth and patient testimonials as shoddy evidence.

Regrettably, scientists have only a few studies showing correlations between the quality-of-life changes and chiropractic care. Most scientific clinical studies suggest chiropractic as a treatment for adult low-back pain, thus limiting chiropractic care.

The public only hears: “…there is no evidence that any chiropractic treatment works for infants and/or kids.”  (Healthwatcher.net) – or – “I am not aware of any chiropractic research that has led to any significant improvement in patient care.” (Stephen Barrett, MD)

Supporters of chiropractic care are aware of this false perception and its negative affects on the general public.

“The dearth of defensible information about chiropractic and chiropractors is still hampering our external ability to integrate successfully with the rest of the so-called health industry…. Let’s face it. We have a massive fact deficit in chiropractic.” (William Meeker, DC, MPH, FICC, director of the Palmer Center for Chiropractic Research)

“Whether the practice of chiropractic is of any value to the patient cannot be known with certainty until a scientific base has been established. …It is clearly apparent that it would be beneficial to the public for the profession to systematically study the subluxation as it relates to the health of the patient. Chiropractic can be observed and measured.” (The National Upper Cervical Chiropractic Research Association)

“The Committee believes additional research is necessary to further quantify the already‑known benefits of chiropractic care.” (US Senate Appropriations Committee hearings on ‘Health Care Access and Cost Containment Strategies’)

“Evidence of the value of spinal manipulation for problems other than low-back pain is less extensive, and the role that subluxation (of other forms of joint dysfunction) may play in causing and/or providing relief through adjusting is uncertain.” (“In the Quest for Cultural Authority,” Joseph Keating, DC, et. a., Dynamic Chiropractic, December 16, 2004.)

“The claim that loss of neural integrity influences ‘organ system function and general health’ is also unsubstantiated by currently available experimental data. … assertions may be appropriate as hypotheses (tentative assertions) and proto-theories (from which testable propositions may be derived), and deserve our critical attention by means of research. However, to assert their validity in the absence of hard scientific data is to engage in dogmatism.” (Joseph Keating, Dynamic Chiropractic, Dec. 16, 2004)

The answer lies in thoroughly conducted scientific research and observing the mechanisms surrounding chiropractic care such as stress reduction on the autonomic nervous system and wellness. The results must then be reviewed by chiropractic experts and other professionals with the appropriate credentials to write and review research reports.  At that time, reports should be submitted to major health journals for publication.

It’s insufficient to research solely manual manipulation’s effectiveness as a resolution for musculoskeletal conditions such as low-back pain. Such technicalities only reemphasize the false belief that chiropractic is just physical therapy that can be provided by regular physician and physical therapists. Should this remain to be the only field of chiropractic research, it will be utilized as evidence to limit chiropractic care.

The chiropractic theory claims that stress on the nervous system negatively impacts overall wellness.  Such health-like components like immunity, vitality, and well-being must be measured.  It is essential to conduct research to confirm this supposal.

Research must compare and contrast the individual’s state of health before and after receiving chiropractic care. Our goal is to develop a standard rating system measuring the severity of stress on the nervous system and integrating it to measure the noteworthy result of chiropractic care. With this rating system, the next step is to create a formula connecting outcome results and the impact on a patient’s level of stress.

This method has gained popularity in epidemiology. It is also used for studying sleep apnea severities. (Journal of Subluxation Research, 3:24-30, 1999.) Upon completion, this formula will function as a universal standard for chiropractic care and wellness.

A detailed analysis of database findings of millions of chiropractic patients can disclose direct links between stress and wellness. The findings could lead to ground-breaking information regarding the impact of chiropractic on the human nervous system and overall health.

About the Author
Terry A. Rondberg, DC, is a leading proponent of research to demonstrate the benefits of chiropractic care on patients, not only for back pain but also for the brain, the heart, the nervous system and total body wellness. He is a sought-after public speaker, author and advocate for millions of chiropractic patients and practitioners.

Neurofeedback, like chiropractic, has proven effective for migraines and tension headaches, urinary incontinence, high blood pressure, anxiety, and other conditions. Increasing research indicates that neurofeedback, like chiropractic, is useful for attention deficit hyperactivity disorder, while helping manage patients with autism, brain injury, posttraumatic stress, seizures, and depression. Corporate executives, musicians, artists, and athletes, including some medalists from the Beijing Olympic Games, used neurofeedback and chiropractic to reach their peak performance during competition.

U.S. soldiers returning from war use neurofeedback to help with post-traumatic stress disorder. People suffering from chronic pain often find relief with neurofeedback. Even athletes are using it to gain better control over their bodies.

Students at Iowa State University have access to neurofeedback to help with stress management.  For over a century, millions of people have benefited from chiropractic care for stress reduction. The students sit in a quiet, dark room, wearing noise-suppressing headphones and sensors on their fingertips that measure their heart rate and skin conductance. They practice relaxation techniques while watching real-time graphics demonstrate how their body is responding. As a result, they see which techniques lead to actual relaxation.

Once users of neurofeedback learn what techniques alter their body’s physiology, they can practice until they have learned the techniques. Then they have tools to use when necessary.  Neurofeedback stress evaluation studies have demonstrated the enormous benefits of chiropractic care along with neurofeedback.

Neurofeedback addresses brain disregulation. This includes anxiety-depression, attention deficit, behavior disorders, various sleep disorders, headaches and migraines, PMS and emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy. Neurofeedback provides training for self-regulation. Self-regulation is necessary for good brain function and training allows the central nervous system to function more efficiently.

Regarding organic brain disorders, it can only be a matter of getting the brain to function better rather than curing the condition. When it comes to problems associated with disregulation, there is not a disease to be cured. Where disregulation is the problem, self-regulation may be the remedy.  But the word cure would not apply.

Over the years, many Neurofeedback (EEG) training protocols have been developed to help with certain problems such as attention, anxiety, depression, seizures, migraines, and cognitive function. There are different assessment tools available to help determine which protocols to use. These are simple neuropsychological evaluations. We use the NeuroInfiniti.

According to a recent national survey by the U.S. Centers for Disease Control and Prevention, more than one in nine children and teens use herbal supplements or some type of alternative medicine.

This is the first time children’s use of such remedies, including meditation and chiropractic care, has been measured. Adult use of alternative care remains about the same as it was in 2002 — more than one in three.

Given that children are generally healthy, the finding that one in nine uses alternative medicine is astounding.

The study is based on a 2007 survey of more than 23,000 adults who discussed themselves and more than 9,000 adults who spoke on behalf of a child in their home.

The adults most likely to report using alternative care were women, college graduates and those who live on the West Coast. Among most adults, alternative care was used equally by those with private health insurance and those without.

Children were five times more likely to use alternative care if a parent did. Those covered by private health insurance were more likely to use alternative care than children who were uninsured or covered by public programs.

In 2002, adult use was 36 percent, compared to 38 percent in 2009.

In this decade, many academic medical centers and other mainstream health care providers have integrated alternative care into their research and patient services. Chiropractors can be found in general hospitals. Insurance coverage and licensing of alternative care is on the rise.

There were differences in how the 2002 and 2007 surveys were conducted. Regarding herbal remedies, the 2007 study asked participants whether they had used such a product in the previous 30 days, while the 2002 study asked if they had taken it in the past year.

In both studies, herbal remedies were the most popular form of alternative care for adults. In the latest survey, nearly one in five adults reported taking a supplement in the previous month.

For adults, pain was the primary reason for seeking chiropractic care.

About the Author – Dr. Terry Rondberg
Terry A. Rondberg, DC, is a nationally recognized author, speaker and publisher on chiropractic care and wellness. He’s an outspoken proponent of chiropractic and drug-free healthcare.

Part Two of a Two-Part Series.

The dominant anatomical feature of our brain is the undulating surface of the cerebrum – the deep clefts are known as sulci and its folds are gyri. The cerebrum is the largest part of the brain and is largely composed of the two cerebral hemispheres. In terms of evolution, it is the most recently developed brain structure, dealing with more complex cognitive brain activities.

It is often said the right hemisphere is more creative and emotional while the left deals with logic, but the reality is more complex. Nonetheless, the two sides have some specializations, with the left focusing on speech and language and the right focusing on spatial and body awareness.

Further anatomical divisions of the cerebral hemispheres are the occipital lobe at the back of the brain and the parietal lobe positioned above the occipital lobe. The former lobe is devoted to vision, while the latter controls movement, position, orientation and calculation.

Behind the ears and temples lie the temporal lobes, dealing with sound, speech comprehension and some aspects of memory. To the fore are the frontal and prefrontal lobes, often considered the most highly developed and most “human” of regions, controlling thought, decision making, planning, conceptualizing, attention control and working memory. They also deal with various social emotions such as regret, morality and empathy.

Another classification is the sensory cortex and motor cortex, controlling incoming information and outgoing behavior, respectively.

Below the cerebral hemispheres, but still referred to as part of the forebrain, is the cingulate cortex, which directs behavior and pain. Beneath it lies the corpus callosum, connecting the two sides of the brain. Another significant area of the forebrain is the basal ganglia, responsible for movement, motivation and reward.

Beneath the forebrain lie more primitive brain regions. The limbic system, common to mammals, deals with urges and appetites. Meanwhile, the brain structures of the amygdala, caudate nucleus and putamen are most closely linked with emotions. The limbic brain also houses: the hippocampus – vital for memory formation; the thalamus – a sort of sensory relay station; and the hypothalamus, which is reponsible for regulating bodily functions.

The back of the brain has a highly convoluted and folded swelling called the cerebellum, which stores movement patterns, habits and repeated tasks – actions we perform without much thought.

The most primitive parts, the midbrain and brain stem, control the bodily functions we conduct subconsciously, such as breathing, heart rate, blood pressure, and sleep patterns. These parts of the brain also control signals that pass through the spinal cord between the brain and the rest of the body.

Though we have discovered an enormous amount of information about the brain, crucial mysteries remain. For instance, how does the brain produces our conscious experiences?

The majority of the brain’s activity is subconscious. But our conscious thoughts, sensations and perceptions, which define us as humans, have yet to be explained by brain activity.

About the Author – Terry A. Rondberg, DC.

Dr. Terry Rondberg received his Doctor of Chiropractic (DC) at Logan College, and has gone on to found the World Chiropractic Alliance, The Chiropractic Journal, and author several books on chiropractic and wellness.

Part One of a Two-Part Series.

The brain, it is said, is the most complex organ in the human body. It produces our thoughts, actions, memories, feelings and experiences. This jelly-like mass of tissue, weighing about 1.4 kilograms, contains one hundred billion nerve cells, or neurons.

The complexity of the connectivity among these cells is mind-boggling. Each neuron can make contact with tens of thousands of other neurons, via tiny structures called synapses. In fact, our brains form a million new connections for each and every second of our lives. The pattern and strength of the connections is continuously changing and no two brains are identical.

In these changing connections, memories are stored, habits are learned and personalities are shaped, from reinforcement of certain brain activity patterns and losing others.

While most people know about “gray matter,” the brain also contains white matter. The gray matter is the cell bodies of the neurons, while the white matter is the branching network of thread-like tendrils, called dendrites and axons. They spread out from the cell bodies to connect to other neurons.

Another cell is the glial cells. These outnumber neurons ten times over. Once thought to be support cells, they are now known to amplify neural signals and to be as important as neurons in mental calculations. There are many different types of neurons, only one of which is unique to humans while the other is unique to great apes, the so-called spindle cells.

Brain structure is shaped in part by genes, but mostly by our experiences. In fact, via a process called neurogenesis, new brain cells are being created throughout our lives. The brain experiences bursts of growth and also periods of consolidation, when excess connections are pared. The most notable bursts are in the first two or three years of life, during puberty, and also a final burst during young adulthood.

Brain maturity also depends on genes and lifestyle. Exercising the brain and proper nutrition are just as important as it is for the rest of the body.

Our neurons communicate in various ways. Signals pass among them by the release and capture of neurotransmitter and neuromodulator chemicals, such as glutamate, dopamine, acetylcholine, noradrenalin, serotonin and endorphins.

Some neurochemicals work in the synapse, passing specific messages from release sites to collection sites, called receptors. Others also spread their influence more widely, like a radio signal, making whole brain regions more or less sensitive.

Deficiencies in certain neurochemicals are linked to disease. For example, a lack of dopamine in the basal ganglia (the part of the brain that controls movement) leads to Parkinson’s disease. It can also increase susceptibility to addiction because dopamine affects our sensations of reward and pleasure.

Similarly, a deficiency in serotonin, used by regions controlling the emotion, can be linked to depression or mood disorders, and the loss of acetylcholine in the cerebral cortex is characteristic of Alzheimer’s disease.

Within individual neurons, signals are formed by electrochemical pulses. This electrical activity can be detected by an electroencephalogram (EEG), placed outside the scalp . These signals have wave-like patterns, which scientists classify from alpha (common while we are relaxing or sleeping), to gamma (active thought). When this activity goes awry, it is called a seizure. Some researchers think that synchronizing the activity in different brain regions is important for perception.

There are other, indirect ways of imaging brain activity. Functional magnetic resonance imaging or positron emission tomography monitor blood flow. MRI scans, computed tomography scans and diffusion tensor images (DTI) use the magnetic signatures of different tissues, X-ray absorption, or the movement of water molecules in those tissues, to image the brain.

These and other scanning techniques have helped determine which parts of the brain are associated with which functions. For example, different parts of the brain govern activity related to sensations, movement, libido, choices, regrets and motivations. However, some experts argue that we put too much trust in these results, which also raise privacy issues.

Before scanning techniques, researchers relied on patients with brain damage caused by strokes, head injuries or illnesses, to determine which brain areas perform certain functions. This approach exposed the regions connected to emotions, dreams, memory, language, perception and to more enigmatic events, such as religious or “paranormal” experiences.

One famous example was the case of Phineas Gage, a 19th century railroad worker who lost part of the front of his brain when a 1-metre-long iron pole blasted through his head during an explosion. He recovered physically, but experienced permanent personality change, showing for the first time that specific brain regions are linked to different processes.

About the Author – Terry A. Rondberg, DC

Dr. Terry Rondberg is has been a champion of the chiropractic profession for decades. After receiving his Doctor of Chiropractic (DC), Dr. Rondberg founded The Chiropractic Journal, the industry’s first professionally edited source for chiropractic news and features.

Terry Rondberg

Chiropractic Instrumentation

Not long ago, the only “instrumentation” chiropractors needed was their own hands. We palpated for subluxations, conducted relatively simple range-of-motion or leg length exams, and detected subluxations and corrected them.  Later, we obtained X-Ray machines that helped verify our visual and manual findings, although we never relied solely on this machine and still remained confident in our sense of touch and sight. That, however, was before outcome measurements, evidence-based practices, reliance on third-party payers, and an appreciation for the science as well as the art and philosophy of chiropractic.

Over the years there have been several developments in instrumentation for chiropractic use: weight scales, postural measuring, galvanic skin response measurements, para-spinal thermal devises etc. Although much of the instrumentation has provided valuable information for Chiropractic, it has been rated as scientifically unacceptable and has given non-reproducible results.

Earlier chiropractic instrumentation was bulky, awkward, and hard to use. I often wonder how many doctors and staff members gave up trying to learn about their new equipment and how much of that equipment is now sitting in a corner. I have seen some classified ads on popular Internet websites.  Here are some of the actual descriptions for sEMG machines on sale:

• “Brand-new condition; rarely used.”
• “Unit is like brand new, Less than 2 years old and used only about a dozen times.”
• “All in great condition, dynamic SEMG never used.”
• “Great condition — rarely used.”

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“Today, in order to deliver the safest and most effective chiropractic care to our patients, and satisfy the more stringent requirements of the insurance industry, the government, and the courts, we must go beyond just feeling for subluxations.” – Terry A. Rondberg, DC

Thanks to computerized techniques, we now gather a wide range of data for neurological activity, leading to a better understanding of normal/ideal functional levels.  Surface electromyography (sEMG) and para-spinal thermal scans made a huge contribution about 12 to 15 years ago. While these seemed to support the chiropractic position of spinal care and joint mechanics, one must question if this deals with cause?  Furthermore, X-Rays, sEMG and thermal scans offer a static view of a dynamic being.  To base any care on a single static view is questionable. These instruments have served their purpose, which demonstrates the value of objective measurements in replacing the anecdotal foundations of chiropractic. It is better to move towards objective evidence than just sharing our philosophy and telling the chiropractic story.

In addition to sEMG, inclinometry and infrared temperature evaluations, instrumentation provides the ability to perform stress assessments and neurofeedback.  Much of this was developed by doctors of chiropractic Richard Barwell and Ken Vinton; it translates all data into detailed neurological reports that validate and document all clinical findings and guide health care decisions. This equates to the survival of modern chiropractic practice and plays an important role in case of a lawsuit or board complaint. Another reason to choose the NeuroInfiniti Instrumentation is that it is currently the only reliable system that allows field doctors to participate in a global research project that will prove the effects of how correcting vertebral subluxation impacts the autonomic nervous system while proving the real value of chiropractic care. The ultimate goal is to accumulate and analyze objective data from all the doctors who use the NeuroInfiniti to demonstrate the efficacy of chiropractic, to elevate our professions acceptance insure our rightful place in the health care professions.

We need powerful instrumentation that not only aids us in detecting subluxations, but provides an accurate outcome assessment system which correlates the value of what we do. Since chiropractic is the largest natural health care system in the world, we need the highest quality instrumentation. Let’s not settle for less.

We are working with state-of-the-art instrumentation developed for chiropractic that will transform chiropractic offices into the most effective, health care resources ever offered to the public.  A scientific evidence based practice will act as a patient magnet, drawing families into your office so you can provide the finest chiropractic care.

We do not often have the opportunity to revolutionize our offices, dramatically increase our patient volume and revenue, help more people lead healthier lives, and contribute to research validating what DD and BJ represented.  Chiropractic is a fast-moving profession.  Physicians can either join the frontrunners or be left in the dust.  They can either create the practice and the profession of their dreams today or they can continue to do nothing.

About the Author – Terry A. Rondberg, DC.
As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is the author of myriad, thought-provoking articles in the wellness field. He is the author of several best-selling books on the subject of chiropractic, and is a sought-after speaker at medical events worldwide.

Part Three of three articles.

In a previous Journal article, although medical authorities acknowledge neurological complications may occur as a result of subluxation, classical chiropractic definitions mandate the presence of a neurological component.  Researcher, Charles Lantz, PhD, DC, writes, “Common to all concepts of subluxation are some form of kinesiological dysfunction and some form of neurological involvement.”

Nevertheless, we’re often ignoring that neurological involvement.  As a result, we are known as back-pain doctors and used the same way as aspirin or exercise equipment: to relieve musculoskeletal stiffness and pain.  One reason is we were sold a bill of goods to find a “niche” market. Back pain, we were told, was a lucrative market, with nearly eight of every ten adults suffering from it at one time or another. We thought the medical profession would allow us to treat back pain as long as we did not invade their territory.

It was also less complicated to describe how chiropractic could ease back pain than it was to explain the entire vitalistic philosophy.  It was also easier to advertise.  All we had to do was show a person with red lightning bolts radiating from his or her back or neck and we were in business!

The final reason we ignored the neurological component was that we didn’t have the scientific research to prove what we knew from clinical experience.  As Dr. Davila says, “We need to show a neurological connection to the subluxation so we have the proof we have talked about over the years and then tie that connection to functional improvement.”
Why then is so much of our current research focused on back pain and similar musculoskeletal conditions?  Here, for instance, is the complete list of all the projects funded by FCER last year:

• “Chiropractic Dosage for Lumbar Stenosis”
• “Chiropractic and Acute Neck Pain: A Practice-Based Study”
• “Preventive Care of Chronic Cervical Pain and Disabilities: Comparison of Spinal Manipulative Therapy and Individualized Home Exercise Programs”
• “Does Chiropractic Care Decrease Fall Risk in Older Adults?”  (The grant description notes that: “It is proposed that balance, the risk factor for falls, is adversely affected by both musculoskeletal function and low back and lower extremity pain — which have been found to be responsive in previous studies to chiropractic intervention.”)

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Do you see the pattern here?  Instead of locking our profession in the miniscule musculoskeletal box, we need to reclaim the missing component of subluxation: neurological involvement. The World Chiropractic Alliance is dedicated to this mission.  We must discuss with our patients and members of the community, integrating it in our patient education programs. It is also necessary to redesign our advertising so we are not reinforcing the old, erroneous idea of back pain doctors. Furthermore, we should demand that our colleges and research institutions stop plucking the low-hanging fruit by examining the connection between chiropractic and back pain! Field doctors need to start using the NeuroInfiniti instrumentation to accurately measure a patient’s neurological response before and after subluxation correction, and learn to document vital information for use not only in research but for the government and all insurance companies.

In the hundred-plus years since DD Palmer discovered chiropractic, we’ve lost much of the spirit and substance of chiropractic. If we lose the neurological component of the subluxation, we will lose our original identity and possibly, our future.

I don’t want to wait until someday for chiropractic validation. Certainly, you do not wish to wait to transform your office into a smooth-running and modern, scientific evidence-based practice, with easy-to-use technology that maximizes your patient outcomes AND your bottom line! However, we do not need to wait until that elusive someday.  We can have it all NOW.

About the Author – Terry A. Rondberg, DC.
As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is known worldwide as one of the chiropractic profession’s leading proponents. After receiving his Doctor of Chiropractic (DC) Dr. Rondberg began publishing The Chiropractic Journal, a leading publication in the field. In addition to publishing the Journal—which continues to be an authoritative reference for chiropractic practitioners and professionals —Dr. Terry Rondberg has written a number of best-selling books on the subject of chiropractic.

Part Two of three articles.

Understanding the brain is fascinating, but I must caution that despite stunning achievements, scientists know little about how we apply our knowledge to real-world settings. If we understood how the brain knows to pick up a glass of water to drink, that would be a major achievement. Non-scientists understand even less. I encourage everyone to be a bit skeptical about what they read in the popular press. Occasionally, I read an article that states the new brain science can improve business practice, and I’ll say, “Really?” We use our brains in business management, but it’s premature to predict how the revolution in neuroscience will affect the way executives manage their organizations.

Some things we’ve learned have great practical value. Let’s examine the impact of stress on the brain. Stress hurts the brain, which inevitably affects workplace productivity. The brain was created to survive jungles and grasslands and to endure acute stress. For instance, a saber-toothed tiger will either eat a human or force him to run away. In either case, the stress level decreases in less than a minute. One can have several of these spikes throughout the day and cope. In fact, stress is beneficial since it makes our muscles move. But man was created to handle stress for only 30 to 60 seconds. Today, our stress level is measured not in moments with mountain lions, but in hours, days, and months, as we experience hectic careers, screaming toddlers, marital issues, and financial problems. Our bodies aren’t built for this kind of ongoing stress. If you have the tiger at your doorstep for years, then various internal mechanisms break down, from sleep rhythms to specific parts of the immune system. Enduring chronic stress resembles taking an airplane and sticking it in water. Just like the airplane wasn’t built to be in water, the brain wasn’t built to endure chronic stress.

The biggest disgrace of modern medicine involves physicians prescribing unnecessary drugs that have not been thoroughly researched and performing unproven procedures on patients. This is one reason why more than 100,000 people die each year in the U.S. due to the medical care they are given.  Thank God for chiropractic.  But are we any different? We adjust patients on the premise that subluxations have a negative affect on their health, but do we have valid, scientific evidence to support this claim? We know this is true from our first hand clinical experience and we have some research for corroboration, but we do not yet have the necessary, indisputable evidence that accompanies large-scale clinical outcomes. We expect that someday we will prove to the world that the neuromusculoskeletal changes resulting from chiropractic adjustments can result in life-enhancing affect on all organic functions. Research will show that chiropractic strengthens the immune system, aids the body to defend against a variety of diseases and conditions, while improving the quality of life which we believe leads to a longer, healthier and happier life.

Too often chiropractic is viewed as a treatment for musculoskeletal disorders, disregarding the neurological aspect. When I first read The Chiropractic Journal’s commentary, “Do you want to re-define medical necessity?” by John Davila, DC, I found myself nodding vigorously in agreement, especially when he states, “The neurological component of the subluxation is our greatest weapon to expanding the definition of medical necessity.”

We will see in the next article how ignoring the neurological component of chiropractic is harmful to the profession.

About the Author – Terry A. Rondberg, DC.

As CEO of the World Chiropractic Alliance, Dr. Terry Rondberg is known globally as one of the chiropractic profession’s leading figures. For decades, he has shown tremendous commitment to the chiropractic profession. After receiving his Doctor of Chiropractic (DC) Dr. Rondberg began publishing The Chiropractic Journal, a professionally edited news source for chiropractic. In addition to publishing the Journal, Dr. Rondberg has written a number of best-selling books on the subject of chiropractic.