Chiropractic Treatment

[Lala81]

you have known such people with success on physiotherapy doesn't give ammunition for people to criticise chiropractic treatment when they themselves have not tried it to cure their back problems.

 

physiotherapy does have its efficacies but like @watwheels have mentioned, everyone's level of affliction is different and it would be too presumptious to assume that what works for one person will work for another person.  and for the 3 persons i cited, 2 of them also tried doing physiotherapy exercises on top of going to the chiropractor.  1 even consulted orthopedic specialist before.

 

some objectivity is required.

 

I've heard of cases of patients who suffered vertebral fractures after going to chiropracter.

You can say it's tiagong or what ... up to you to believe.

 

Basically it's up to you lah.

U can let whoever touch your back or even better, your neck.

 

Just know that if they do something and make it worse. There's zero recourse in Singapore. 

[Lala81]

I did it over 6 months, 2-3x a week and it didn't work for me. It worsened my condition actually.

 

I have also read enough to know a thing or 2, won't say it is totally useless, it works for some, but the amount charged for 5-10 mins of "adjustment", 2-3x a week, is just gross. Some people are making a lot of money, hence so much hard sell.

 

Even if u can manipulate your spine to these "ideal" positions, so what?

Your back is made up of a spinal column supported by opposing muscles, if the muscle tension is biased towards one side, a child can tell you that the "ideal" position is not going to be maintained.

Does anyone really think even a 45min session over 3-4 times a week is going to change anything.

Hello, the other 23hr 15min of the day, your muscles are going to do exactly what they been doing for the donkey years before that. 

 

This is not even talking about strengthening your core, your upper back, gluteals, hamstrings, loosing your hip flexors etc 

[Acemundo]

I've heard of cases of patients who suffered vertebral fractures after going to chiropracter.

You can say it's tiagong or what ... up to you to believe.

 

Basically it's up to you lah.

U can let whoever touch your back or even better, your neck.

 

Just know that if they do something and make it worse. There's zero recourse in Singapore. 

 

my point is that people seem to be too easy having a go at all chiropractors without even first hand experience of the pain of the patient or the level of expertise of the particular chiropractor.  citing that other people have good experience with physiotherapy, as an alternative to chiro, doesn't prove that chiropractors are all bad.  if i like to drink coke, doesn't mean i definitely will find the taste of pepsi bad or better still, another different person will not necessarily find that the taste of pepsi bad.

 

some folks (not referring to you) can even allude that those with positive feedback about their chiropractor as being effects of deluded by placebo.  these are the people that are bigoted in thinking lowly of intelligence of patients who don't think the same as them despite themselves not being in the shoes of the  patients to experience the pain and treatment.  

 

this is somewhat like the perception of TCM from doubting thomas for the longest of time.  the loudest critic are usually those who never tried it and even opinionated, to say the least. .  even though TCM is regulated now, it hasn't made these doubting thomas any more quieter in their criticism.

 

most people don't go into anything first thinking it will fail and putting recourse as the priority consideration.  eg how many go into marriage thinking about the recourse from divorce?  even if we should think about failure and recourse, priority consideration has to be whether the patient gets cured or have his pains sufficiently alleviated.  eg even if one have to believe that marriage will have a high chance of failing, it shouldn't condition his mind to write off all gals from his marriage but instead, for him to be more selective and find the one that have a best match with him.  he should be in better position than mere bystander to assess this.

 

like you said, it is tiagong only plus the expertise of each chiropractor will differ.  even with regulated medical industry, recourse is seldom actually pursued even when the doctors havent been appropriate in the treatment and brought about other medical problems as a result of it.  in this case, i am not merely quoting from tiagong but from cases i personally know and close to the patients.

Even if u can manipulate your spine to these "ideal" positions, so what?

Your back is made up of a spinal column supported by opposing muscles, if the muscle tension is biased towards one side, a child can tell you that the "ideal" position is not going to be maintained.

Does anyone really think even a 45min session over 3-4 times a week is going to change anything.

Hello, the other 23hr 15min of the day, your muscles are going to do exactly what they been doing for the donkey years before that. 

 

This is not even talking about strengthening your core, your upper back, gluteals, hamstrings, loosing your hip flexors etc 

 

now you are going into the permanent fix/cure argument.

 

fact is even orthopedic specialists can't guarantee a cure. or for that matter, many medical conditions that accredited or qualified doctors can't permanently cure or fix.

 

again to use such an argument against chiropractic practice when it affects the same to even all the regulated/accredited/qualified doctors is not appropriate.

[Lala81]

In my opinion, it's ok to be skeptical when someone promises you a quick fix.

Even if it comes from a medical professional.

Refer to above.

 

my point is that people seem to be too easy having a go at all chiropractors without even first hand experience of the pain of the patient or the level of expertise of the particular chiropractor.  citing that other people have good experience with physiotherapy, as an alternative to chiro, doesn't prove that chiropractors are all bad.  if i like to drink coke, doesn't mean i definitely will find the taste of pepsi bad or better still, another different person will not necessarily find that the taste of pepsi bad.

 

some folks (not referring to you) can even allude that those with positive feedback about their chiropractor as being effects of deluded by placebo.  these are the people that are bigoted in thinking lowly of intelligence of patients who don't think the same as them despite themselves not being in the shoes of the  patients to experience the pain and treatment.  

 

this is somewhat like the perception of TCM from doubting thomas for the longest of time.  the loudest critic are usually those who never tried it and even opinionated, to say the least. .  even though TCM is regulated now, it hasn't made these doubting thomas any more quieter in their criticism.

 

most people don't go into anything first thinking it will fail and putting recourse as the priority consideration.  eg how many go into marriage thinking about the recourse from divorce?  even if we should think about failure and recourse, priority consideration has to be whether the patient gets cured or have his pains sufficiently alleviated.  eg even if one have to believe that marriage will have a high chance of failing, it shouldn't condition his mind to write off all gals from his marriage but instead, for him to be more selective and find the one that have a best match with him.  he should be in better position than mere bystander to assess this.

 

like you said, it is tiagong only plus the expertise of each chiropractor will differ.  even with regulated medical industry, recourse is seldom actually pursued even when the doctors havent been appropriate in the treatment and brought about other medical problems as a result of it.  in this case, i am not merely quoting from tiagong but from cases i personally know and close to the patients.

 

now you are going into the permanent fix/cure argument.

 

fact is even orthopedic specialists can't guarantee a cure. or for that matter, many medical conditions that accredited or qualified doctors can't permanently cure or fix.

 

again to use such an argument against chiropractic practice when it affects the same to even all the regulated/accredited/qualified doctors is not appropriate.

 

Edited May 9, 2018 by Lala81

[Acemundo]

In my opinion, it's ok to be skeptical when someone promises you a quick fix.

Even if it comes from a medical professional.

Refer to above.

 

but you were not the one being given the promised.  how would you know what is promised or for that matter, "a quick fix" promise as you quoted?

 

even if the promise is over the board, isn't this what happens in all industry including the regulated medical industry?  such things is highly dependent on the particular consultant or professional and to be alluded about the industry (practitioners and patients) as a whole.  

Edited May 9, 2018 by Acemundo

[Lala81]

you want to talk statistics?

Sure.

 

Systematic review (worse case injury is verterbal artery dissection) after spinal manipulation.

 

 

 

Go to:

Abstract

Objective To identify adverse effects of spinal manipulation.

Design Systematic review of papers published since 2001.

Setting Six electronic databases.

Main outcome measures Reports of adverse effects published between January 2001 and June 2006. There were no restrictions according to language of publication or research design of the reports.

Results The searches identified 32 case reports, four case series, two prospective series, three case-control studies and three surveys. In case reports or case series, more than 200 patients were suspected to have been seriously harmed. The most common serious adverse effects were due to vertebral artery dissections. The two prospective reports suggested that relatively mild adverse effects occur in 30% to 61% of all patients. The case-control studies suggested a causal relationship between spinal manipulation and the adverse effect. The survey data indicated that even serious adverse effects are rarely reported in the medical literature.

Conclusions Spinal manipulation, particularly when performed on the upper spine, is frequently associated with mild to moderate adverse effects. It can also result in serious complications such as vertebral artery dissection followed by stroke. Currently, the incidence of such events is not known. In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.

 

With any procedure, there's always risk and benefit involved.

 

Always ask what's the risk of injury vs benefit. 

Edited May 9, 2018 by Lala81

[Lala81]

as you grow older, your ligaments become more calcified and stiffer, your joints may already be having osteophytes, some of them even bridging the joint space.

 

So basically your spine becomes more rigid like old bamboo instead of young bamboo 

[Etnt]

as you grow older, your ligaments become more calcified and stiffer, your joints may already be having osteophytes, some of them even bridging the joint space.

 

So basically your spine becomes more rigid like old bamboo instead of young bamboo 

 

I'm suddenly reminded of Rush Hour,

 

"Don't worry, chinese bamboo, very strong"

[Acemundo]

you want to talk statistics?

Sure.

 

Systematic review (worse case injury is verterbal artery dissection) after spinal manipulation.

 

 

 

With any procedure, there's always risk and benefit involved.

 

Always ask what's the risk of injury vs benefit. 

 

is this meant for me?  i assumed it is

 

anyhow, i didn't refer to statistics in terms of failure or cure rates.  what i am saying is, why some people can adopt the stand that they know better when they are not personally in the situation and condition.  why only quote the bad cases and ignore the good ones.

 

as a trained statistician, i dare say statistics can be manipulated (sample selection, control of parameters and variables) to suit the agenda of the person behind it.  2 months ago i had a big debate with a colleague who is biased against TCM and as expected, quoted inappropriate statistics to lend to his argument.

 

back to the most critical point - when a patient got problem he is engaging 1 chiropractor or 1 TCM at any one time and not the entire chiropractic or tcm practice.  if he can find one that treats his problem effectively, why should anyone be bothered by what the rest of the peers in those industry does and puts down this person's positive testimony?

Edited May 9, 2018 by Acemundo

[Lala81]

is this meant for me?  i assumed it is

 

anyhow, i didn't refer to statistics in terms of failure or cure rates.  what i am saying is, why some people can adopt the stand that they know better when they are not personally in the situation and condition.  why only quote the bad cases and ignore the good ones.

 

as a trained statistician, i dare say statistics can be manipulated (sample selection, control of parameters and variables) to suit the agenda of the person behind it.  2 months ago i had a big debate with a colleague who is biased against TCM and as expected, quoted inappropriate statistics to lend to his argument.

 

back to the most critical point - when a patient got problem he is engaging 1 chiropractor or 1 TCM at any one time and not the entire chiropractic or tcm practice.  if he can find one that treats his problem effectively, why should anyone be bothered by what the rest of the peers in those industry does and puts down this person's positive testimony?

 

You're right. Statistics can be manipulated.

 

But these are definite cases of injury with association with spinal manipulation.

I didn't read the papers, so i can't even say whether these are casual relationships.

But definitely association is there. It's just a matter of how strong or how good the studies are.

If the chiropracters are based in hospital and proper studies are being funded by US/European medical research, then we'll really know whether they are safe. But given a lack of papers out there, it's hard to comment on general safety other then serious injuries have been reported.

 

You can say that incidence is not known, just like whether there were 100,000 cases of spinal manipulation with only 1 serious injury. But do we discount the serious injury just because the other 99,999 were not?

Again, that was what evidence based medicine was meant to do. Evaluate whether treatments really work and also look for patterns of HARM that might arise which a single practitioner will never ever encounter in his/her lifetime.

 

Yes to the fact that I won't ever have any other way to evaluate other than anecdotal information from others.

I will never have first hand experience cos i will never ever let anyone (physiotherapist, masseuse, chiropracter/osteopath) manipulate my spine period.

My BIL goes back massage like every week for donkey years and he has a TCM sinseh master whom he sees for more serious problem.

 

But it's obvious his problems are mostly muscle issue, so i never say anything as well. My mum also went to the master before for other wrist injuries etc.

 

So yes, if u find someone who works well for you, sure great. If that someone hurt u and hurt u permenantly, well that's just too bad.

[Acemundo]

You're right. Statistics can be manipulated.

 

But these are definite cases of injury with association with spinal manipulation.

I didn't read the papers, so i can't even say whether these are casual relationships.

But definitely association is there. It's just a matter of how strong or how good the studies are.

If the chiropracters are based in hospital and proper studies are being funded by US/European medical research, then we'll really know whether they are safe. But given a lack of papers out there, it's hard to comment on general safety other then serious injuries have been reported.

 

You can say that incidence is not known, just like whether there were 100,000 cases of spinal manipulation with only 1 serious injury. But do we discount the serious injury just because the other 99,999 were not?

Again, that was what evidence based medicine was meant to do. Evaluate whether treatments really work and also look for patterns of HARM that might arise which a single practitioner will never ever encounter in his/her lifetime.

 

Yes to the fact that I won't ever have any other way to evaluate other than anecdotal information from others.

I will never have first hand experience cos i will never ever let anyone (physiotherapist, masseuse, chiropracter/osteopath) manipulate my spine period.

 

i have nothing against this latest post you exchanging with me because you finally took a step back and agree this is your opinion from far and also stopped suggesting alternative treatments to patients.

 

i am not coming out to defend chiropractic practice but coming out to speak up against people who impose their views on people who are actually closer to the ground ie the patients themselves and the patients' closest kin.  this has been my stand consistently from the first post i made on this thread and I will not contest further if this is not the point being challenged upon.

 

 

 

So yes, if u find someone who works well for you, sure great. If that someone hurt u and hurt u permenantly, well that's just too bad.

thanks but no thanks to your condescending kindness.  i can manage my own health better than any one else thinks he can help me. 

Edited May 9, 2018 by Acemundo

[Lala81]

i have nothing against this latest post you exchanging with me because you finally took a step back and agree this is your opinion from far and also stopped suggesting alternative treatments to patients.

 

i am not coming out to defend chiropractic practice but coming out to speak up against people who impose their views on people who are actually closer to the ground ie the patients themselves and the patients' closest kin.  this has been my stand consistently from the first post i made on this thread and I will not contest further if this is not the point being challenged upon.

 

To me, as a medical professional, when i say anything or recommend anything. We are conservative.

We are always thinking about harm.

 

Frankly more than half the time, we aren't thinking about why you SHOULD do the treatment, we are thinking why you have a case NOT to do the treatment. Because the DON'T part actually has greater implications and probably give us more worry.

 

So if someone ask u to do something cos it will fix your problem, then best to ask what is the alternative lor. The problem is that decision paralysis can easily come into play. Even the way the professional offers the odds has been known to affect our pyschological decision.

 

Do know that a trained asker, can manipulate your decision towards one direction, just by the way he/her lead the questions.

 

Similarly, over the years, i know how to present my information in a way tailored to the patient. For someone who's overeager, i may emphasis the side effects or WCS. For someone who's hesitant, i may present it in a way that's more easy for them to make a decision.

[Acemundo]

To me, as a medical professional, when i say anything or recommend anything. We are conservative.

We are always thinking about harm.

 

Frankly more than half the time, we aren't thinking about why you SHOULD do the treatment, we are thinking why you have a case NOT to do the treatment. Because the DON'T part actually has greater implications and probably give us more worry.

 

So if someone ask u to do something cos it will fix your problem, then best to ask what is the alternative lor. The problem is that decision paralysis can easily come into play. Even the way the professional offers the odds has been known to affect our pyschological decision.

 

Do know that a trained asker, can manipulate your decision towards one direction, just by the way he/her lead the questions.

 

 

 

for the first 2 paras, i actually wish to applaud you for this.  perhaps it was out of good intentions that you engaged in this disparaging of chiropractic treatment and i have not completely understood your intentions.  but to be fair, in one of the earlier paras i exchanged with you, i specifically mentioned, it was not against you that i referring to someone who slighted patients' positive testimony as placebo.  I merely continued this exchange with you because you started replying and contesting to my comments. 

 

as to your para 4, i absolutely agree although i would say different listener have different levels of sophistication and we cannot assume all will be taken in by any trained asker.  i am a skeptic in many ways and have never agreed with any point of view at face value or too quickly.

[Lala81]

for the first 2 paras, i actually wish to applaud you for this.  perhaps it was out of good intentions that you engaged in this disparaging of chiropractic treatment and i have not completely understood your intentions.  but to be fair, in one of the earlier paras i exchanged with you, i specifically mentioned, it was not against you that i referring to someone who slighted patients' positive testimony as placebo.  I merely continued this exchange with you because you started replying and contesting to my comments. 

 

as to your para 4, i absolutely agree although i would say different listener have different levels of sophistication and we cannot assume all will be taken in by any trained asker.  i am a skeptic in many ways and have never agreed with any point of view at face value or too quickly.

 

Strictly speaking, placebo effect is difficult for a lay person to understand how strong the effect is until they see it in a trial or study. Is your subjective opinion (even with the use of scoring charts) etc really influenced by placebo or something beyond that?

All doctors make use of it to some extent lol 

[Acemundo]

Strictly speaking, placebo effect is difficult for a lay person to understand how strong the effect is until they see it in a trial or study. Is your subjective opinion (even with the use of scoring charts) etc really influenced by placebo or something beyond that?

All doctors make use of it to some extent lol 

 

i disagree on this point.  how can equipment tell me if i experienced pain better than my ownself..  furthermore, equipment does not measure my condition continuously, but i experience the condition continously.  at 1 point in time, we can still argue that the brain deludes me into thinking.  but over a prolonged period of time, it is not possible that the conditioning of thoughts can continue to hoodwink the brain.

 

perhaps if the affliction is cellular (eg cancer) in nature, maybe equipment can better assess especially when the cells are small.  but this one is muscular and nothing like cancer.

[Lala81]

i disagree on this point.  how can equipment tell me if i experienced pain better than my ownself..  furthermore, equipment does not measure my condition continuously, but i experience the condition continously.  at 1 point in time, we can still argue that the brain deludes me into thinking.  but over a prolonged period of time, it is not possible that the conditioning of thoughts can continue to hoodwink the brain.

 

perhaps if the affliction is cellular (eg cancer) in nature, maybe equipment can better assess especially when the cells are small.  but this one is muscular and nothing like cancer.

 

I just give you an example.

 

If you are in pain and i tell you that I can give you an injection for your pain if you are ok.

I can inject normal salt water and 20% of patients will feel their pain has improved. This is using a scoring chart that you self report with a 1-10 scoring.

That is the placebo effect. In my line of work, if you like the doctor, u will feel it works even better 

 

Patients who take the exact same painkiller in a nice packaging (nice box, nicely sealed etc) vs a crummy plain jane tablet, will report that the nice expensive tablet improved their pain better.

 

Even how you perceive pain can be influenced.

Almost everyone remembers peak pain rather than chronic pain. So u could have pain 8/10 for 1 minute vs pain score 4/10 for 2 minutes. Theoretically, the pain burden is similar.

But after the episodes, u will remember the peak pain episode as being worse.

[Acemundo]

I just give you an example.

 

If you are in pain and i tell you that I can give you an injection for your pain if you are ok.

I can inject normal salt water and 20% of patients will feel their pain has improved. This is using a scoring chart that you self report with a 1-10 scoring.

That is the placebo effect. In my line of work, if you like the doctor, u will feel it works even better 

 

Patients who take the exact same painkiller in a nice packaging (nice box, nicely sealed etc) vs a crummy plain jane tablet, will report that the nice expensive tablet improved their pain better.

 

Even how you perceive pain can be influenced.

Almost everyone remembers peak pain rather than chronic pain. So u could have pain 8/10 for 1 minute vs pain score 4/10 for 2 minutes. Theoretically, the pain burden is similar.

But after the episodes, u will remember the peak pain episode as being worse.

 

again this is possible only for short period of treatment and research window but over the longer period, the effects should have been attenuated or even out.  also it will differ according to patient's intelligence or rational vs conditionable mind as well.  many patients does not mean all and even the backdrop of the patients and their afflictions are different.      

[Lala81]

again this is possible only for short period of treatment and research window but over the longer period, the effects should have been attenuated or even out.  also it will differ according to patient's intelligence or rational vs conditionable mind as well.  many patients does not mean all and even the backdrop of the patients and their afflictions are different.      

 

In my personal experience, you'd be surprised, it's not usually about intelligence or successful people being harder to influence.

I consistently meet people who are successful/intelligent in all other aspects of their lives, but remain prone to obvious biases. 

 

Of course, these are broad observations which play out over the general study population. 

 

A skeptic is the hardest to persuade. So the skill to teach our children, is to be skeptical. Even of their own lao peh and lao bu