Frank M. Painter

The Subluxation Complex Saves Diagnosis for Texas Chiropractors

By Frank M. Painter|June 14, 2012|Announcement, Diagnosis, Evaluation & Management, Subluxation|

The Subluxation Complex Saves Diagnosis for Texas Chiropractors

SOURCE: Dynamic Chiropractic

By James Edwards, DC

On April 5, 2012, the Third Court of Appeals of Texas issued a 58-page opinion in Cause No. 03-10-673-CV – the Texas Board of Chiropractic Examiners (TBCE) and the Texas Chiropractic Association (TCA) vs. the Texas Medical Association (TMA), the Texas Medical Board (TMB) and the State of Texas.

According to an April 6, 2012 communication by the Texas Chiropractic Association [1], the case presented three questions for the court:

1) Are the two TBCE rules that allow chiropractors to make certain “diagnoses” valid?2) Can chiropractors perform MUA?3) Can chiropractors perform needle EMG?Here’s what the Court of Appeals had to say in the matter:

Diagnosis

On the two most important issues presented by the TCA, the Court of Appeals upheld the validity of TBCE’s Rules 75.17(d)(1)(A) and (B) (“the scope of practice rules”). The first rule, 75.17(d)(1)(A), permits chiropractors to render diagnoses “regarding the biomechanical condition of the spine and musculoskeletal system,” and lists six typical diagnostic areas as examples of what is within the scope of practice. At the district court level, Judge Yelenosky had struck down that rule, stating that it created an unlimited authorization to diagnose any disease or condition, which, he said, exceeded chiropractors’ scope of practice.

The Court of Appeals disagreed and reversed Judge Yelenosky’s decision. The court found that the TBCE rule does not exceed the scope of practice because the rule limits chiropractors to making diagnoses of the biomechanical condition of the spine and musculoskeletal system.

The second rule, 75.17(d)(1)(B), permits chiropractors to diagnose subluxation complexes of the spine or musculoskeletal system, and lists three examples of what is within the scope of practice. The Texas Medical Association and Texas Medical Board had challenged that rule, claiming that the rule allowed chiropractors to diagnose neurological conditions, and pathological and neurophysiological consequences that affect the spine and musculoskeletal system. At the district court level, Judge Yelenosky agreed and struck down the rule because he found that it expanded the scope of chiropractic beyond what was allowed in the Chiropractic Act.

Again, the Court of Appeals disagreed with District Court Judge Yelenosky. The appeals court acknowledged that a subluxation complex could have functional or pathological consequences that affect essentially every part of the body. But the court found that the rule itself only allowed chiropractors to render a diagnosis regarding a subluxation complex of the spine or musculoskeletal system. That authority, the appeals court held, was consistent with the Chiropractic Act. (more…)

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Strokes May Seem Rare, But Can Occur 230% More Often Using The Pill

By Frank M. Painter|June 14, 2012|Announcement, Oral Contraceptives, Public Health, Stroke|

Strokes May Seem Rare, But Can Occur 230% More Often Using The Pill

The Chiro.Org Blog

SOURCE: MedPage Today ~ June 13, 2012

By Todd Neale, Senior Staff Writer

A large Danish registry study found that the risks of thrombotic stroke or myocardial infarction (MI) roughly doubled in women taking oral contraceptives with low-to-moderate doses of ethinyl estradiol.

Note that the overall number of thrombotic strokes or MIs was small.

The relative risks of thrombotic stroke and myocardial infarction (MI) are higher among users of hormonal contraception, although absolute risks remain low, a Danish study showed.

Use of oral contraceptives combining low-to-moderate doses of ethinyl estradiol and various progestins was associated with up to 2.3 times the risks of thrombotic stroke or MI compared with non-use, according to Øjvind Lidegaard, DrMedSci, of Copenhagen University Hospital, and colleagues.

The type of progestin in the pill had little effect on the risks, the researchers reported in the June 14 issue of the New England Journal of Medicine.

To put the risk in perspective, they estimated that among 10,000 women taking a pill combining desogestrel with ethinyl estradiol at a dose of 20 μg for 1 year, two will have arterial thrombosis and seven will have venous thrombosis.

(more…)

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Wake Up – We’re in a Race for Scientific Ownership of Manipulation

By Frank M. Painter|June 13, 2012|Research, Warning!|

Wake Up – We’re in a Race for Scientific Ownership of Manipulation

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By William Meeker, DC, MPH, FICC

For several years now, many have pointed out that our major clinical intervention, that family of procedures we call adjustments/manipulation, is no longer a “quack” remedy. That designation changed dramatically over a decade ago with the publication of the RAND appropriateness studies, the AHCPR guidelines on back conditions, and a fair number of randomized clinical trials.

Historically, those studies were very powerful in pulling manipulation out of the closet to where it now is – experiencing a great deal more exposure. As a result, we are seeing a renaissance of interest by osteopathic physicians and physical therapists. This in turn has led to a significant increase in the amount of research on manipulation by these professions. They are challenging chiropractic for pre-eminence in this field.

Professions, by definition, “own” their tools and their knowledge. This means that there is a cultural consensus in society that expertise in the use of professional knowledge is invested in a particular profession because that profession knows the most, is the most expert in, and can do the most good for the public with its unique tools. Lawyers know the most about laws because they make laws, study laws and apply laws. You wouldn’t go to a plumber if you had a legal case. Obviously, the situation is analogous for health care.

A citizen should not have any trouble deciding whom to consult for specific kinds of clinical expertise. But the situation for manipulation is becoming increasingly muddy, if the scientific publication record is any indication. We chiropractors do not enjoy an unassailable cultural consensus anymore when it comes to manipulation and adjustments. Chiropractors certainly have some authority by virtue of our history and training, but others are encroaching. We need to recognize that our authority in this area is under concerted and constant attack, and I fear that we may be losing ground. (more…)

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TMJ Trauma and Its Rehabilitation

By Frank M. Painter|June 12, 2012|Chiropractic Care, Evaluation & Management, TMJ|

TMJ Trauma and Its Rehabilitation

The Chiro.Org Blog

Clinical Monograph 13

By R. C. Schafer, DC, PhD, FICC

TEMPOROMANDIBULAR JOINT DYSFUNCTION

Proper treatment of TMJ dysfunction must be based on a thorough case history, a complete physical workup, an evaluation of the cranial respiratory impulse and craniosacral mechanisms, and a detailed examination of the TMJ, cranium, and cervical spine. Unfortunately, radiographs to determine abnormal joint space are rarely successful unless over 30% of the bone has been destroyed.

A blow to the jaw is easily transmitted to the temporal bones. As mentioned previously, osteopathic research suggests that a subluxated temporal bone is often the focal fault. This is reported to be grossly indicated by flattening (temporal internal rotation) or protrusion (temporal external rotation) of an ear from the skull.

Symptomatology

The major symptoms of TMJ dysfunction are masticator muscle fatigue and pain, which are usually described as a severe, unilateral (rarely bilateral), dull facial ache that is often fairly localized to an area just anterior to the tragus of the ear. The onset of pain is gradual, progressively increasing over several days or months. It is aggravated by chewing and opening and closing the mouth. Precipitation is often made by eating an apple, a wide yawn, snorkeling, prolonged dental work, playing a wind instrument, prolonged chewing, a bump or pressure on the mandible, sleeping in the prone position, or a cervical whiplash.

You may also enjoy our page on:

Chiropractic Rehabilitation Page

(more…)

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Forearm and Wrist Trauma

By Frank M. Painter|June 11, 2012|Chiropractic Care, Diagnosis, Evaluation & Management|

Forearm and Wrist Trauma

The Chiro.Org Blog

Clinical Monograph 18

By R. C. Schafer, DC, PhD, FICC

As with most parts of the body, traumatic effects in the forearm or wrist may occur abruptly (eg, fracture, strain, sprain) or be the result of long-term microtrauma (eg, tunnel syndromes, arthritis, entrapment by scar tissue).

BACKGROUND

Screening injuries of the forearm and wrist

Joint Motion Restriction

Restriction in pronation suggests a disorder at the elbow, radioulnar articulation of the wrist, or within the forearm. Restriction in supination is associated with a disorder of the elbow or radioulnar articulation of the wrist. Thickened tissues may cause compression symptoms. A palpable nontender ganglion may be found on either the dorsal or volar aspect of the wrist, perceived as a pea-size or slightly larger jelly-like cyst.

Significance of Tenderness

Tenderness over the medial collateral ligament, which rises from the medial epicondyle, is a sign of valgus sprain. Muscle tenderness in the wrist flexor-extensor group is characteristic of flexor-pronator strain (eg, tennis, screwdriving motions). Tender, possibly taut, wrist extensors on the lateral aspect are often associated with tennis elbow. Tenderness in the first tunnel on the radial side is a common site for stenosing tenosynovitis associated with a positive Finkelstein’s sign. (more…)

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The Use of Botanicals During Pregnancy and Lactation

By Frank M. Painter|June 10, 2012|Complementary and Alternative Medicine, Supplementation|

The Use of Botanicals During Pregnancy and Lactation

The Chiro.Org Blog

SOURCE: Alt Ther in Health and Med 2009 (Jan); 15 (1): 54-58 ~ FULL TEXT

Tieraona Low Dog, MD

Arizona Center for Integrative Medicine,
University of Arizona Health Sciences Center, Tucson

Women are the largest consumers of healthcare, and this extends to their utilization of complementary and alternative medicine (CAM). Researchers have attempted to uncover the reasons why women turn to CAM in general and to botanical medicine in particular. Desire to have personal control over their health has been cited as the strongest motive for women to use herbal medicine. Second was dissatisfaction with conventional treatment and its disregard for a holistic approach, as well as concerns about the side effects of medications. [1]

These concerns may explain, in part, the fact that many women use herbal remedies during pregnancy. A survey of 578 pregnant women in the eastern United States reported that 45% of respondents had used herbal medicines, [2] and a survey of 588 women in Australia revealed that 36% had used at least 1 herbal product during pregnancy. [2] Women probably feel comfortable using herbal remedies because of their perceived safety, easy access, and the widespread availability of information about them (ie, Internet, magazines, books).

While it is true that many botanicals are mild in both treatment effects and side effects, the data regarding safety during pregnancy are very limited. Given the small sample sizes in clinical trials studying botanicals in pregnant women, only large differences in measures of pregnancy outcomes would likely be detected. For example, if an herb were thought to increase the rate of spontaneous abortion from 6% to 7%, a sample size of more than 19,000 women would be needed (to actually demonstrate that effect). It is highly unlikely that there will be any studies of a botanical (or any drug for that matter) with this large a sample size. (more…)

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About Frank M. Painter

The Subluxation Complex Saves Diagnosis for Texas Chiropractors

The Subluxation Complex Saves Diagnosis for Texas Chiropractors

Strokes May Seem Rare, But Can Occur 230% More Often Using The Pill

Strokes May Seem Rare, But Can Occur 230% More Often Using The Pill

Wake Up – We’re in a Race for Scientific Ownership of Manipulation

Wake Up – We’re in a Race for Scientific Ownership of Manipulation

TMJ Trauma and Its Rehabilitation

TMJ Trauma and Its Rehabilitation

Forearm and Wrist Trauma

Forearm and Wrist Trauma

The Use of Botanicals During Pregnancy and Lactation

The Use of Botanicals During Pregnancy and Lactation