View Full Version : Re: spinal "adjustment"

12-07-1998, 03:39 AM
I am sorry for this late reply but I found a response to this in my
e-mail drafts folder, did not receive a summary and thus believe I did
not send it out.

Although you did not ask for this to be addressed I would like to
comment on the differences between adjustments and manipulations.
Although the chiropractic profession has developed definitions for both
terms through consensus process.(1) I personally believe the only
difference is in the mind of the person using the terms. Chiropractors
generally believe that manipulation (or thrusting in to joints not done
by chiropractors) is less specific than adjustments (thrusts performed
by chiropractors). I have read numerous papers by PTs, DOs and MDs
where they allege that the their method of manual treatment is more
specific then that used by chiropractors.

This is a situation that I would have thought could have only emanated
from the mind of a TV situation comedy writer, if it were not reality.
Both sides accuse the other of being non-specific in their treatments
while "knowing" that their method is most specific. Being a student of
these arts I would say that there are DCs, PTs, DOs and MDs who are
very specific manipulators and there are DCs, PTs, DOs and MDs who are
very gross and non-specific manipulators. Thus, the quality of one's
manual skills is not dependent on the profession one has studied but in
the hands that have done the studying. And finally we do not have any
data that I am aware of that shows that specificity is important. There
is however data which suggests that manipulation (Maitland Grade V) is
more effective than mobilization (Maitland function or symptoms which advertantly or inadvetantly alter their segmental
> spial mobility. In spite of years of research and multitudes of conflicting
> claims, it is unclear what the factor or factors are that limit this
> movement; whether it is muscular, structural, or some other factor or
> combination.e We know if we apply treatment modalities these patterns
> change, and that people's symptoms can be reduced and mobility restored. The
> effective treatment modalities include the above and other manual
> techniques, some electrotherapies, acupuncture, hypnosis, ice, heat, and
> many others. Each on occaison produces seemingly miraculous results on
> previously unresponsive symptoms. On average (as in controlled studies) a
> significant difference may be hard to detect between different modalities or
> systems, but for an individual, one system is often more effective than
> another.
> Belief in what we do goes a long way towards enchancing its effectiveness.
> It is part of the theraputic process that the practitioner believes in what
> he is doing. I am sure that the vast majority of practitioners are sincerely
> interested in the welfare of their clients, but I am also sure that there
> are many who provide unduly expensive, ineffective, or potentially harmful
> interventions. How many clients if they were told that they had even one
> chance in a million of having a CVA after having their cervical spine
> treated would have it done. (There is no evidence that the tests intended to
> reduce this incidence or the elimination of certain techniques has produced
> the desired results.) Needless to say I am sure there are always other ways
> of effectively treating neck problems without the risks that accompany
> manipulations or adjustments.
> Please address replies to me and I will forward a summary so those not
> interested in this discussion will only have to delete one more message.
> Regards
> Neil Tuttle
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__________________________________________________ ___________________
Stephen M. Perle, D.C. "A man who knows that
Assistant Professor of Clinical Sciences he is a fool is not
University of Bridgeport College of Chiropractic a great fool."
Bridgeport, CT 06601 Chuang Tzu
E-mail: perle@bridgeport.edu
__________________________________________________ ___________________

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