One of the major concerns for chiropractors are stroke patients. Current research associates the risk of stroke after a cervical manipulation as about 1 in a million. However, these stats may be artificially high, since often people who seek chiropractic care for neck & head pain often have these symptoms because they are currently in a stroke status. Read the rest of this entry »
Archive for category Experiments
New Stroke Recognition Tests
Nov 19
Is it really worth it?
Discography, a painful imaging technique for the spine that involves the injection of a contrast medium, has long been debated for its efficacy and utility(1,2,3). Even though it has been around since 1948, research to this day still fails to establish Discography as a effective test. It has been suggested that it is an accurate test for only a minute group of conditions, while it is unreliable for disk degeneration, disk bulges and protrusions, as it lacks specificity and leads to unnecessary back surgery (4). Regardless, this procedure is still sees widespread usage as doctors argue it is better than MRI or CT.
New research published in Spine, decided to take a different role, and examine the risks to benefits ratio of a discography. In their experimental animal model, it was shown that the rats that received small needle punctures exhibited a significantly higher rate of herniation, endplate changes, disc grade progression and annular fissures; both in frequency and severity. They also demonstrated a statistically significant decrease in disk height and signal after the injection (5).
Dr. Carragee et al.’s study brings up serious concerns with the usage of discography. Why countinue to utilize a technique that has been so poorly proven to provide usable & correct clinical data, and that also causes what you are attempting to locate and fix. It appears that this is a classic case of Risks far outweighing the benefits. Read the rest of this entry »
Placebo Effect Seen on MRI
Oct 19
MRI
In October’s issue of Science a study showed a physiological response to a placebo topical analgesia. This article addresses the study design and findings, and concludes with its relation to chiropractic.
The study contained a population of 13 subjects, who were told that they were part of a trial to test the efficacy of a new pain killer cream. First patients were exposed to a painful heat source on their arm, and then researchers applied the ‘control cream’ (which was the same cream as the supposed pain-reducing cream). The patients’ pain ratings were then recorded. Next, researchers repeated the experiment but this time with the pain reducing cream, however, after administering the cream they lowered the temperature of the heat source without informing the patient. Therefore, the patients felt less pain with the pain-reducing cream.
In the second phase of the study, researchers performed functional MRIs at the C5-C6 junction on the patient while exposing the arm to a painful heat stimulus. One part of the forearm was covered with the ‘control’ and the other with the ‘pain-reducing’ cream; each spot was exposed 25 times and at the same heat. The placebo effect took hold, and patients reported an average of 26% less pain in the analgesic arm.
Of course, proving the placebo effect is nothing new. What is amazing is that the fMRIs revealed that the ipsilateral dorsal horns lit up when the ‘control’ was exposed to the heat, but did not equally activate during the ‘pain-killer’ trials. Read the rest of this entry »
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