Popping joints

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[AtomicGrooves]

I have a problem with poping writs, knees, ankles and even fingers. Sometimes it hurts and other times it doeans't. When it does the pain is quick but sharp. My kneck goes through some of that too! Can anyone suggest anything?

:freaky:


Atomic

[SeiserL]

IMHO, get a physical, see a chiroprator, get a massage, stretch and warm up. Joints should not be popping and hurting.

[AtomicGrooves]

Thanks, I'll do just that. I knew it wasn't normal. I guess I just needed to hear someone confirm it for me.

[Don_Modesto]

IMHO, get a physical, see a chiroprator, get a massage, stretch and warm up. Joints should not be popping and hurting.
If it hurts, that's obviously a problem. But my joints pop all the time and it's not a problem. (What's really disconcerting is when someone else's joints pop while I'm applying some technique on them...)

[aikidoc]

Popping joints can mean several things. Sometimes joints just release normally. Repetitive popping several times in a row is most likely a tendon slipping over a ridge of bone. A gravel sound in the neck or back can indicate degenerative arthritis. Pain accompanying the popping is not normal. In the knees, it can indicate a torn meniscus. In the shoulder it could indicate spurs damaging the rotator cuff tendons. Crepitus (grinding sounds) in the hands could indicate destruction in the joints.

See a chiro or osteopath then a specialist if necessary (orthopedist, rheumatologist).\

John Riggs, D.C.

[AtomicGrooves]

Wow! I'll do that just as soon as I get a chance. Do you think I should put my aikido practice on hold until I find out what the problem is?

[Kevin Wilbanks]

Wow! I'll do that just as soon as I get a chance. Do you think I should put my aikido practice on hold until I find out what the problem is?
In my view, putting any aspect of your life on hold in anticipation of the advice of a Chiropractor would be extremely foolish. The Chiro seeks to foster your dependency upon them and secure the resulting income stream as a matter of theory and policy. Don't just hand them the goods before they even get a chance to ply you with their propaganda just because a couple of people on the net made a suggestion. There is no evidence that Chiropractic treatment accomplishes anything beyond temporary relief of back pain of certain kinds. As a whole, the profession seems curiously uninterested in submitting their practices to even basic epidemiological analysis, much less placebo-controlled scientific testing... coincidence? Its theoretical edifice has more in common with palmistry and nephrology than contemporary science.

While the possibilities John laid out seem roughly correct, what Don says is also correct - many people experience popping and strange joint movements/sounds throughout life without noticable ill effects. It would be difficult to make a responsible recommendation for evaluation or treatment based upon the little you've said, although it might be safe to recommend a consult with an experienced sports med M.D. to rule out some dire possibilites and possibly make a referral to a specialist or a physical therapist if necessary.

Are we talking about something that makes you wince and involuntarily vocalize or alter a movement pattern, or something that is annoying when you think about it too much? Do you have hypochondriac tendencies? Before I would recommend anything expensive or life-altering, I would want to know what movements cause the pops and more about the pain. If the pops occur during stretches and "warm-up" exercises or only during pins and joint-torquing techniques, this is a vastly different matter than if they occur every time you bend your knees or raise your arms. Likewise, the significance of the pain would have to be placed in the context of it's intensity and frequency of occurence, and how you perceive and experience pain generally.

[aikidoc]

Wow! A totally uncalled for attack on me and the chiropractic profession. Kevin, before you attack someone you need to be aware of the research literature. There is more research supporting manipulation as a mode of treatment than for a lot of the medical treatments available. Surgery is a prime example. The side effects are also much less. This is not to say that the profession does not have its problems and problem children but to make such a generalized attack and to put us in the category of palm readers and head bump readers is not only inaccurate but also uncalled for and obviously biased. Are you a physical therapist? What are your qualifications to make such erroneous assumptions. I expect something like this from Mike L. but not you given post I have read in the past.

First, you put me in the category of all chiropractors and I have never considered myself such. I don't even like the term "subluxation" used by the profession since the term is too broad and inherently vague. Second, I provided advice that is based on sound anatomy/physiology not theory. This is advice provided by any orthopedically trained person. I have by the way completed two years of additional post graduate training in orthopedics and have published in a journal referenced in the Indicus medicus (medical index).

Apparently, you have had exposure to bad DCs who put marketing, practice building and philosophy above the treatment of the patient. I do not-probably why I'm not rich. Why is it these forums seem to degenerative into personal attacks based on the biases of invididuals. Especially, in a forum based on the art of harmony.

I agree you have the right to not like DCs and to have your opinions but I feel your attack was biased and uncalled for-my opinion.

[aikidoc]

P.S.

I was not suggesting Vladimir stop training but to get professional help. A sports medicine specialist is also a good choice. A recent study shows 78% of MDs flunk a basic musculoskeletal test (this comes from Medscape). Osteopaths and DCs focus their practices in this area and that's why I suggested one.

[aikidoc]

Correction: that is supposed to be Idex Medicus. Sorry about that.

[MikeE]

Jeez John, I hate to see you have to defend yourself and your chosen profession like that.

I myself, have more a problem with western medicine. I see a MD once a year for my physical and blood work and such. I see my DC and DOM for everything else.

I had MDs treating my lower back pain for years with pain meds and anti-inflammatories. Didn't work. My DC became one of my students about 5 years ago and has great knowledge (from a biochemistry background) of minerals, vitamins, herbology and such. This with finding what was causing the problem, has taken care of it.

Many times western med just treats symptoms and ignores the underlying problem. That's why I love chiropractors.

(This was an unpaid endorsement) :)

[AtomicGrooves]

Wow. ok. Thanks guys, well I'll answer as best I can. I believe pain can be an envirioment that you can ignore like hot or cold weather but there are times when you need to listen. The confusing thing is it happens when I'm stretching, it happens when my joints feel stiff and uncomfortable. It happens when I do pull ups. My waiste is fine, my toes, ankles and knees it happens if I move in particular ways. The only joints that really seem to hurt when they pop is my shoulders (mostly the left) and both wrist (again mostly the left. When I do Seiza it sounds like a bowl or rice cripies (snap crackle pop!) My other classmates don't seem to make those noises that's why I was a little worried. I probably should have discussed this with my sensei. I feel like a real idiot for not thinking of it sooner. Does any of this sound normal to you guys?

I don't wanna stop my training. It took me awhile to find an art that I liked and save the money (I'm a musician, sometimes the money doesn't flow like it should). I'm committed but I want to solve the problem. Or atleast understand what I can do. Or if I can ignore it all together.

[Kevin Wilbanks]

John,

I was not singling you out, and did not even read your profile to know you are a chiropractor. Of course I am biased against Chiropractic - there is no such thing as being unbiased, and since I was obviously slamming the practice, this seems trivially true.

I did have a bad experience with a Chiro, but this is not the basis of my criticism, the experience only fit into it. I do think he believed his own nonsense and thought he could help me, but instead he merely wasted my time and money. At the time, I was willing to try anything, and his sham muscle testing techniques were very convincing. But, in the long run, his treatments did nothing but expose me to unnecessary risk of debilitating neck injury, cost me a lot of money I couldn't really afford, and waste time that I could have spent purusing a useful therapy or rehab regimen. The emphasis was always on the value of the manipulations he could do for me, not what I could do for myself. When I experienced no results, he continually urged me to rest and lay off activity more, blaming me for exercising too much and having a self-destructive workout habit. Of course, if you rest, you'll experience less pain... how convenient... My experience illustrated what I think is the worst part of the whole chiropractic philosophy: fostering dependence on regular chiro treatments instead of self-sufficiency.

The similarities between the theory of Chiropractic, as originated by D.D. Palmer, nephrology, and palmistry are not trivial: all claim that subtle variations in a particular favored body part have mysterious and telling connections to the organism as a whole. And, all three are based upon made-up theories that have little to do with science. Of course, Chiro goes one better than merely using the favored part to read and diagnose, it also claims that any number of maladies in the organism can be treated by subtly adjusting the magical body part.

The emphasis on "subluxations" is unsupported nonsense: there is simply no evidence that the spine is so intolerant of such minor deviances from an assumed ideal, and even less that such deviances are connected with any ailments. If you have some, send me the references. I am not making assumptions, and my authority or similarity to unpopular persons is not relevant - only evidence is. I claim that there is none, so I am under onus to provide nothing.

Perhaps Chiropractic's worst secret is the fact that neck manipulations represent a real health risk of potentially catastrophic proportions. Since the evidence for benefits from the treatments beyond temporary relief of a minor subset of back pain symptoms is scant, I think this is very serious - much worse than wasting money or time, or even the secondary risk of missing out on potentially more useful treatments.

http://www.quackwatch.org/01QuackeryRelatedTopics/chirostroke.html

A couple more sample useful links from Quackwatch (http://www.quackwatch.org/):

http://www.quackwatch.org/01QuackeryRelatedTopics/chiro.html

http://www.quackwatch.org/01QuackeryRelatedTopics/chirosub.html

[Kevin Wilbanks]

Vladimir,

You say the shoulder is the only joint that hurts, and you mention pullups and stretching. It could be that your shoulder is simply unstable and not moving in healthy, sustainable patterns. The first thing to do is stop stretching it - shoulders need very little stretching. The popular stretch where you grab an object and forcibly stretch the pectoral and front deltoid is especially potentially injurious. Also, you may be doing pullups with poor form. This is why I asked when the pain and noise occurred. If it mostly happens during static stretching and traditional Aikido "warm-ups", then your problem may be that these are poor movements - either unnecessary, risky, or both (most of them are). Since these movements aren't Aikido itself, try doing what I do: go through the motions with everyone, but don't apply any force to the moves. As far as exercises go, learn to do pullups properly, and include other shoulder-involving moves like overhead presses, overhead squats, dips, strict pushups, and rows - also done properly.

I had bad tendonitis in both shoulders before I changed my movement patterns, strengthened them, and stopped static stretching. Now they are highly injury resistant and I have no problems

As far as all the other popping goes, I'd go to a doctor who has some sports med or orthopedic expertise just for peace of mind (I agree that general MD's may be of little use).

[YEME]

The confusing thing is it happens when I'm stretching, it happens when my joints feel stiff and uncomfortable. It happens when I do pull ups. My waiste is fine, my toes, ankles and knees it happens if I move in particular ways. The only joints that really seem to hurt when they pop is my shoulders (mostly the left) and both wrist (again mostly the left. When I do Seiza it sounds like a bowl or rice cripies (snap crackle pop!) I don't wanna stop my training. It took me awhile to find an art that I liked and save the money

I'm committed but I want to solve the problem. Or atleast understand what I can do. Or if I can ignore it all together.
I too am a rice crispee victim. Left shoulder crackling also.

The knees/ankles - check for alignment. After years of crackle I had orthotics prescribed...my knees/ankles are completely outta whack. The crackling is due to deterioration. Assuming your prob is same: there's nothing you can do in class. just know that silent movie style ninja action will never happen...

The shoulder: I can manage to make my left upper shoulder crack whenever I stretch. Esp: Mornings...cold days etc.

Mine's arthritis. Its the only joint that causes pain too. Sometimes it dominoes onto elbow/ wrist. I was told to change my diet/ cut out tomatos/caffeine/sugar and eat loads of celery. So far I've only managed the tomato part.

Now I'm not saying you've got the same things going on but they sound similar and its something to check if you're worried.

My general aproach is: if it hurts get it checked. If it doesn't - it'll hurt in 10 years time and there's probably nothing u can do to stop that.

i feel like an old woman sharing health problems over tea and cookies at the home...

[aikidoc]

Kevin. Now I understand where you are coming from. The Quackwatch organization of Stephen Barrett and William Jarvis has been discreted by just about every legitimate organization and court that they have ever been in contact with. If you rely on their tripe for your basis of fact, then I'm sorry since you truly do not believe in doing any research. On the point of your providing back up I disagree. When someone makes attacks not founded in fact then I think they have an onus to back themselves up with relevant research.

The chiropractic profession has its crooks and fanatics like every other profession in the world (we are human). In fact, in our area we had two MDs get it for medicare fraud-one is in prison the other fled the country and they are looking for him. I'm sorry your DC did not know his/her own limits. He/she should have had you on rehab after a couple of weeks anyway. And if not improved within a 2-4 week trial period you should have been referred. The muscle testing was probably applied kinesiology and they have been criticized in the past for not subjecting their claims to research.

The literature is out there and manipulation has been researched strongly (frankly I don't have the time to dig up references for you). The claims about treating everything are made by a limited few-of course the quackbusters group jumps on those. There are medically researched reflexes that do connect with internal organs (somatovisceral and viscerosomato reflexes) that have been well researched by Irwin Korr, PhD and Michigan State University. However, claims of all diseases coming from the spine are made by a limited few and are irresponsible.

Neck manipulation like any procedure has its risks. The reseach shows however that many of the complications although blamed on chiropractors were actually a result of a massage therapist, MD or other person not qualified to ascertain contraindications (bad research) injuring someone. Using your analogy then we should ban all back surgery since the failure rate and severe complication rate is somewhere in the neighborhood of 30-40%. Complications from neck manipulations run in the area of 1 every 1-10 million. I'd say the percentages were favorable to manipulation over surgery. Both have their places in carefully selected cases.

The issue of subluxations is definitely controversial in the profession. There are those who still believe in the antiquated bone out of place pinched nerve theory. However, this has long been accepted as of little value for most who realize that joint dysfunction is more the issue and nerve facilitation non pinching that causes most of the pain. Normalization of abnormal function helps resolves the issue.

I'm sorry Kevin but your sources are suspect (Quackwatch in particular-a Canadian Judge threw them out of court becauses they were so unscientific and biased and stated they were not able to provide credible information) and your biases evident. Before you attack, do your research. Manipulative research historically was lacking since the drug companies controlled a lot of the research funds. This is changing. We are actually getting federal funding now which is helping the profession provide validity. Historically, the allopathic (MDs) bled people for everything. So do we hold them in this image forever. I'm not anti-allopathic by the way. My school was dubbed as pseudo med by a lot of the other chiro schools since we focused so much on science. I send patients to MDs regularly and get referrals from them as well.

My advice to Vladimir was stated with D.C. at the end of my name so I was out there in establishing where my advice was coming from. The attack was on my statements and chiros immediately so I can only surmise you saw it.

I don't want this to turn into a debate since it is a no win situation. I'm not trying to convince you of anything since that is an impossible task. Your views are your views but I do think you could find better sources than quackwatch.

[PeterR]

Most hospitals here have a Chiropractor and an Acupunturist. Both are tied in with the MDs.

I've gone to all three and all three have referred me to one of the others usually after only a quick examination.

Very professional.

Of course I did meet a wild eyed young man from outside of Japan that claimed acupunture could cure anything from emotional problems to rampant ear infections. He was studying in Osaka somewhere so I guess quacks in both the above must exist.

[aikidoc]

Mike and Peter-thanks for the endorsements. It's changing (for some). In England, they found patients get better faster in hospitals when both work together.

There are quite a few avid aikidoka who are chiros as well. I can think of about 4 just off the top of my head in my limited knowledge base.

[Kevin Wilbanks]

John,

You continue to make a lot of vague and even emotive claims about evidence and research, yet I see no specificity at all. Telling me to do my homework seems like quite a cop-out. The quackwatch articles you decry, on the other hand, are rife with specific references, often hyperlinked to the reference sources in standard medical journals and databases. Your mock-pity for my benightened belief in quackwatch is mere rhetorical flourish - not even quackwatch believes in quackwatch: they provide thorough references for their claims. I wouldn't call the site my primary source, but it's handy, and its elaborately argued and well-referenced specifics speak louder than vagaries. Anyone who reads the articles and checks the references can see this.

Appealing to the authority of some unspecified Canadian judge doesn't do much for me either - the opinion of a Canadian judge is the measure of truth about medical and scientific claims? I asked for some specific references or help in finding them - you merely pile on the heresay, and have yet to provide one reference or any concrete suggestions.

The real problem here seems to be in terms of basic logic and thinking. You don't seem to understand the logic behind skeptism and burden of proof. Your insistence in interpreting skeptical inquiry as "attacks" that need to be grounded in "fact" is pure nonsense. If I claim that there is no evidence of chiropractic claims, what am I supposed to produce to prove it? Every single study in the world that isn't proof of chiropractic claims? Absurd. In fact, most of your arguments are textbook logical fallacies and dirty argumentative tricks, a few of which I've already pointed out - speculative claims about my habits, motivations and character, unflattering comparison to unpopular parties, obfuscation, coined derisive terminology, attacking other disciplines as a diversion... I could go on. Here's another relevant link that you might productively study:

http://www.intrepidsoftware.com/fallacy/toc.php

[PeterR]

Scary stuff on quackwatch.

The time I was sent to the Chiropractic it was because of a painfully stiff neck. It releaved the pain enough that I could function - I have no idea whether it speeded up the healing process. Each time it happened again (working too much on the computer I think) I went back to the same.

No massive neck rotations there.

[Erik]

Kevin. Now I understand where you are coming from. The Quackwatch organization of Stephen Barrett and William Jarvis has been discreted by just about every legitimate organization and court that they have ever been in contact with. If you rely on their tripe for your basis of fact, then I'm sorry since you truly do not believe in doing any research.
For the record,

http://www.chirobase.org/

Kevin is spot on with this one.

[aikidoc]

Ok guys, here’s my last shot at this.

If you really go to the website and read what Barrett and Jarvis use for their examples it is pretty scary (actually read the articles and look at the quality). They use mostly anecdotal information to make their case: marketing information, “victim” testimony or personal experiences, questionable practice building techniques, investigative reports, and questionable diagnostic and treatment practices used by a small portion of the profession. When they do cite research, it is either poor research (case studies, surveys-not double blinds), research later debunked as bad (they don’t point that out), or research by the chiropractic profession itself analyzing its own methods and techniques (dammed if you don’t dammed if you do). I can prove anything I want if I only select the literature that suits my purpose. That does not mean it is objective or balanced. As pointed out by Anthony Rosner, Phd (research scientist) at his testimony discussing research issues to the Institute of Medicine Committee on Use of CAM by the American Public-“Yet we still endure the opinions of past editors of such trusted sources as The New England Journal of Medicine who have debunked alternative medicine as "unscientific," often basing their own theories on the same type of anecdotal evidence that they condemn in various branches of nonorthodox medicine.25,26 Add medical journal articles on cerebrovascular accidents of questionable scientific validity,27-32 plus an onslaught of negative press regarding the safety of manipulation,33-38 that could only be described as a "Petri dish of fetid disinformation of the first magnitude." This is downright embarrassing, almost vaudeville, when you consider that medical practitioners have been shown to have failed validated competency examinations in musculoskeletal medicine.39-41 Instead of abiding by this nonsense, we need to level the playing field instead of the patient!

In an ideal world, scientific debate would be carried on at a high level, and documented evidence would be enthusiastically accepted and incorporated into guidelines and practice.”. . .

Rosner’s summary of the research (with specific references) on spinal manipulation is also noted in the article (see http://www.chiroweb.com/archives/21/10/17.html).

Most the Quackbuster areas of attack on questionable behavior are presented as mainstream. These are the fringes guys. Most of the treatment stuff he cites I’ve never even heard of or seen it advertised. These are not taught in the colleges to my knowledge. The technique gurus (make there own up and then market it), practice builders (teach questionable methods-not good business management), etc., etc. Again, it is the fringe. That would be like me taking the guy in our area (MD) who does peroxide injections and setting him out as representative of the whole medical profession-it serves a purpose if I’m biased, it’s sensational, and I can find other questionable practices to include, but it is not valid. I can also take research studies by the profession debunking this stuff and make it look like it is mainstream medicine and make it look like science is debunking the practices of mainstream medicine-exactly what Quackbusters does. It doesn’t serve their purpose to visit and ethical chiropractor or to cite an article about good practices. It does serve a purpose to jump on the arrests for unethical behavior (we had two MDs arrested for medicare fraud-see where this can go!). They also selectively use portions of the research articles (what few they actually cite) which are negative without putting the whole article in proper context or discussing or quoting the positive portion-I looked up some of the studies they list and most were neutral or had positive statements conveniently overlooked.

I can use all their tactics and get a few testimonials, find some MD bashing chiropractors, and find some cases of bad MDs to suit my bias (got one right now who temporarily paralyzed a patient because he was “impaired” when doing back surgery). Package this together into a “quack website” and then use it to make my case-looks bad but its pure B.S.

A final note on the Barrett/Jarvis group: this was from the New Zealand study on chiropractic- We have considered material published over Barrett's name. The chapter on chiropractic in The Health Robbers (entitled "The Spine Salesmen") was written by him. It is plainly propaganda. What we have seen of the rest of his writings on chiropractic has the same tone. Nothing he has written on chiropractic that we have considered can be relied on as balanced.

14. Other material which we have issued under the auspices of the Lehigh Valley Committee Against health Fraud has features which in our opinion render it unreliable on matters of fact. (The predecessor to the Quackbuster organization).

I do not have any more available time to consider this debate.

[aikidoc]

Forgot the New Zealand reference: Commissioned by the New Zealand Government in 1978, The New Zealand Report (http://www.chiro-org/chiro-list/newsfile/nz-barrett.html.

Their biases were questioned as far back as 1978.

[aikidoc]

Kevin. Your intrepid software reference is good. The quackbusters should read it. Especially the Fallacies of explanation: Non-support (evidence for the phenomenon being explained is biased).

[Erik]

As pointed out by Anthony Rosner, Phd (research scientist) at his testimony discussing research issues to the Institute of Medicine Committee on Use of CAM by the American Public
The rebuttal.

http://www.chirobase.org/14Misc/meeker.html

[aikidoc]

Erik-apples and oranges-that was an article by Haldeman not Posner. The rebuttal was still full of the same approach they are famous for-selective use of their data and not a balanced attack. Again. These are not the same articles-the article I cited was from Feb 2003.

[aikidoc]

Correction. Rosner.

[Kevin Wilbanks]

John,

Thanks for the lenghty explication, but I am familiar with the concept of bias. You seem to be laboring under the delusion that it is possible to be unbiased. The supposed authorities whose opinion you cite as somehow inherently true can be shown to display similar, converse bias, as Erik's link shows. How can you not see the extreme bias and gloss-over implicit in your vague, categorical dismissal of the many hundreds of references in the Quackwatch articles? The abstracts I looked at were standard medical studies and surveys from Medline and Pubmed. We are all subjective entities, and cannot escape this. I don't see how their opinions or a judge's opinions about Barrett are less biased, or even of any significance. What would be of significance would be any study showing that chiropractic consistently accomplishes anything that works better than placebo for any purpose other than temporary relief of certain kinds of back pain, a reasonable interpretation of chiropractic's core theory, or any other valid justification for fostering dependency in patients on expensive ongoing treatments and exposing them to the risks posed by the treatment itself. (By the way, when I plug your 1 in 1 to 10 million incident number into an actual survey of cases conducted among California neurologists, I come up with a Chiropratic-visiting California population of somewhere between 300 million and 3 billion: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7783892&dopt=Abstract)

[aikidoc]

A "survey" of 177 neurologist-now that's a good study. You must have found more medical reference than I did on the quackwatch site-most of them were surveys and case studies. Several were taken out of context or only the negative section quoted. Yes I agree we are all subject to bias. But when a government commissioned study in New Zealand finds these guys less than credible I guess I'd question their input-I know the New Zealander's are biased too. The same type of research shows up regularly in the medical literal on all types of interventions. One of the ways progress is made is by comparing different treatment modalities-surgery vs. epidurals, etc. to see which is more efficacious and cost effective. Rosner does cite several references in his article on studies comparing chiropractic care.

I'm done with this for now. I am not going to convince you these guys have shaky research and shaky interpretation of research presented on their site. I will go look at the rest of their stuff but the sections I reviewed, even when actual research was quoted and I called up the original article it was skewed and a balanced perspective was not presented. Quackwatch has an ax to grind with just about anyone who does not believe the way they do. As an example the Canadian stroke person was attributed to a chiropractic manipulation, which they got a neurologist to support and Barrett et al jumped on the band wagon (until the judge kicked them out of the testimony for lack of credibility). What's interesting is the person had the stroke one month after the manipulation (they don't point that out)-people have had strokes putting their necks in wash bowls at the beauty shops but a month later. Now that's a shaky cause and effect. That would be like taking a pain killer and then a month later having a stroke and blaming it on the pain killer.

I do like to go out an read the quackwatch tripe occasionally for comic relief-it drips with lack of objectivity.

[Erik]

The New Zealand Study from the 'evil ones',

http://www.chirobase.org/05RB/NZ/nzjarvis.html

John, you still seem to be unclear on the concept. It's up to you, and your profession, to provide evidence supporting your claims.

[aikidoc]

Read the following Erik. It's up to the quackbusters to back up their stuff as well if they want credibility. The chiropractic profession is working on it. Read the Rosner article. He notes we have not done bad without the availability of research funds controlled by the drug companies and medical researchers. The literature continues to grow in spite of quackbuster types using our own research against us.

OK Kevin, I decided to give you the benefit of the doubt and take the first section and analyze everything presented with regards to references. Keep in mind these references are used repeatedly in the sections. I did a section by section and then one interesting quote on stroke. All this stuff is from the site-not mine. I think you will note that when the tally is shown my statement would be the hamburger lady statement: where’s the beef with all of this research you cite. A pub med reference does not mean it is research.

Here are the citations for the first section (very time consuming):

Total References for the following sections: 222 (lots of repeats)

Medical References: 64 (lots of repeats)

Actual Research studies: 8 (lots of repeats)

References cited from quackbusters: 22 (repeats as well)

I do not expect this to change for the other sections but where is the research beef? I’m giving the benefit of the doubt by counting repeats. 8 out of 22 (3.6%) for actual research citations. 22/222 or 10% for quackbuster citations. 64/222 (28.8%) for medical references (these are ones appearing to be actual legitimate journals).

I have to say that the research supporting their positions is sorely lacking. Barrett’s law studies (mail order) apparently did not help him in the research support department. Additionally, I noted in his CV that he has not published one article in a refereed journal.

Stroke:

A 1999 review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors [8]. This means that of the ones found in 72 years only 106 cases could be attributed to DCs.

General Articles:

Why is chiropractic controversial? Written by Stephen Barrett MD.

Twenty three articles were cited with only 5 from PubMed. Two of the citations were from Barrett and Homola (both from quackbusters). The rest were not medical publications. Only one was an actual study (Australian) the rest were literature surveys. The Australian study concluded: “The duration of low back pain symptoms was significantly shorter for subjects receiving mobilisation and manipulation; they also achieved symptom-free status with fewer treatment sessions. And . . a stepwise multiple regression analysis showed that treatment is the most significant factor in predicting the length of time before a subject achieves symptom-free status” The Scandinavian study concluded: ““with certain reservations it can be concluded that manipulation of the lumbar spine might have an immediate, short-time effect on low back pain in a limited number of patients. Manipulation has no superior long-term effect as compared to other methods of treatment.”

Chiropractic a Skeptical View. Stephen Barrett MD.

Fifteen articles were referenced for this section: 4 of the 15 were by people connected with the quackbusters (Barrett, Homola, DuVall, Baizer). Not one of the cited references was a study or publication in a medical journal (unless you count a student medical journal).

Chiropractics Elusive “Subluxation” by Stephen Barrett MD

Fourteen references: 3 letters to Barrett (Bodney, Frogley, Koren), 4 from chiropractic practice vendors, one from Health (can’t find anything on whether this is medical or a general publication).

How Chiropractic Subluxation Theory Threatens Public Health by Samuel Homola, DC (quackbusters).

Thirty nine articles cited: 8 appear to be from PubMed references of which 3 were surveys, 2 were position reviews, one a literature review and 2 were studies. One cited reference was from an extreme fringe group. Several cites were from chiropractic practice management gurus (a problem).

Don’t Let Chiropractors Fool You by Stephen Barrett, MD.

Four references: 2 from medical related journals and one from a physical therapy journal. One was a survey (cited before) and another most likely a position paper.

Take it from a DC a Lot of Chiropractic is a Sham by Mark Sanders DC.

No references. Now this is a lot of pure opinion and vague references to behaviors by some chiropractors and practice builders. Some has validity.

Do Pinched Nerves Reduce the flow of Nerve Energy by Stephen Barrett, MD.

No references cited.

NCAHF Position Paper on Chiropractic.

Forty three references: 23 from medical related publications (2 were studies, the rest were cases, literature reviews, or position papers).

NCAHF Fact Sheet 2001 by William Jarvis PhD

Fifty references: 14 from medical related journals (2 were studies, 10 were reports or position statements, 2 were case studies, 1 survey). 9 references were from Quackbusters.

Placebos, Nocebos, and Chiropractic Adjustments by Samuel Homola, DC

Eleven references: 5 from medical journals (no studies). One quacker reference.

Medical Letter on Spinal Manipulation. Now this was interesting. Found no benefit over physical therapy and education for manipulation in neck and low back pain. Did find a benefit over cold packs and massage and as good amitryptiline for non migraneous headaches. It found no significant advantage over sham for asthma, dysmenorrhea, or enuresis. It noted potential complications of stroke and cauda equina. Conclusion: spinal manipulation can cause life threatening complications (now that was objective)



Chiropractors and Immunization by Stephen Barrett.

Twenty six references: 7 medically related journals (one study).

A Message to Chiropractors: Your Real Enemy is Yourself by Stephen Barrett.

Seven references: no medical journals, no studies, 3 references from quackers.

Views of a Reformist Chiropractor by Craig Nelson DC.

No references. I actually agree with the ending: Progressive chiropractors: view chiropractic as integral to the healthcare system in the U.S. and Canada and promote clinical, educational, and research ties between chiropractic and medicine; use diagnostic procedures and principles that satisfy biomedical standards; apply various modes of physiotherapy; have as their treatment goal the conservative managing of neuro-musculoskeletal disorders; regard chiropractic's original principles as of little clinical importance; derive standards of care from scientific research. This is the first objective statement on the site in my opinion and it’s where I’m at professionally.

Why Becoming a Chiropractor may be Risky by William Jarvis, PhD.

No references. Purely opinion.

[aikidoc]

Erik: I think attacking an organization study that finds you less than credible really does little for re-establishing your credibility. Other than writing their own books and position papers very little background in research is noted by the quackbuster crew.

[Kevin Wilbanks]

I'm done with this for now. I am not going to convince you these guys have shaky research and shaky interpretation of research presented on their site.
Of course you're not... at least not by the means you have employed so far. Moreover, doing so would be a mere tangent to the real point of the discussion. The big problem seems to be that you are trafficking in arguments from authority - the notion that certain claims or statements can be deemed true just because certain authoritative people say so. Hence, you have turned the discussion into a referendum on the relative authority of quackwatch, a Canadian judge, three guys in New Zealand, etc... The authority of any of these sources is irrelevant. I never said "Chiropractic is bogus because Dr. Barrett said so." I cited his site as a convenient place to find plausible, logical indictments of Chiropratic claims, replete with references, as an adjunct to similar skeptical points and challenges to the credibility of Chiro I made myself.

References are important. He produces plenty, you produce none - save the opinions of panels, spokespersons and judges, which we are supposed to accept presumably in lieu of any concrete evidence that Chiropractic works. You categorically dismiss all Barrett's references, yet provide no details. The one survey you ridicule specifically puts the number of Chiro-caused injuries in California in a 2 year period in the hundreds. The accuracy of the survey may be questionable, but it looks pretty good against your 1 in 1-10 million figure, which for all I know was made up, at least the survey contains concrete information.

I don't need any references, because I'm the doubter. My 'none' claims aren't provable because I cannot practically produce the set of everything as evidence. On the other hand, 'none' claims can easily be deflated by producing ANY evidence, yet you can't or at least haven't.

On the other hand, references aren't the only thing. I'm willing to tenatively accept, or at least open-mindedly entertain, plenty of notions which I haven't seen validated by multiple peer-reviewed, double-blind, placebo-controlled studies. What I require, at minimum, is at least a plausible explanation for why and how something might work. Neither you nor any other proponent of Chiropractic philosophy and practice has ever done this. All that I have learned of Chiropractic theory sounds as preposterous as what I know of Nephrology: the analogy was not a capricious or hyperbolic one. If I am wrong, and the theories behind Chiro do make sense, and you know why, an actual explanation would go much further than all the vague claims, coined pejoratives, obfuscatory personal remarks, and dueling authority rhetoric you've offered thus far.

[Kevin Wilbanks]

This is the first objective statement on the site in my opinion...
OK. I give up. Chiropract away.

[Aemon_]

DC and DOM
does anyone mind defining these terms for me?thanks!

later

[aikidoc]

Doctor of Chiropractic. Doctor of Oriental Medicine.

[aikidoc]

Kevin. You keep pushing me back into the philosophy/theory category. On that point, we agree. I have used the term subluxation maybe two or 3 times when a real medical subluxation exists. The Rosner reference cites several double blind studies on the effectiveness of manipulation. My main point is that you have lumped all chiros in the same narrow category which is really where the "straight" chiros fall. There are a lot of us like Nelson who don't buy that-guilt by association I guess in your book.

I always have disagreed when people attacking say they don't need to back up their points of view. They ask the person they attack to do so yet the same standards don't apply. There is a lot of research on manipulation. When a crusading organization uses fliers, pamphlets, old articles on devices banned since the 1950s (Toftness), and uses fringe elements to portray a picture representative of a whole profession it is hard to take them seriously. Unfortunately, the public belives it. Now if the effort is to get rid of bad DCs and to make the profession police itself better, then I think there are better methods. The old 80/20 rule. 20% cause problems for 80%.

[Aemon_]

Doctor of Chiropractic. Doctor of Oriental Medicine.
thanks!

[aikidoc]

Erik:

Apples and oranges again. You are using a rebuttal to Haldeman and Meeker to address Rosner's. They are not the same.

[aikidoc]

"On the other hand, references aren't the only thing. I'm willing to tenatively accept, or at least open-mindedly entertain, plenty of notions which I haven't seen validated by multiple peer-reviewed, double-blind, placebo-controlled studies. What I require, at minimum, is at least a plausible explanation for why and how something might work."

OK. You win. Since you aren't willing to do the research on manipulation (it's there by the way for those who chose to look at both sides), I'll see what I can come up with. It will take me a while since it is quite extensive (it gets more research than you can imagine). I will not however try to prove any of the philosophical tenets of the profession since I don't buy into them myself. You can entertain any opinions on that area you choose-an they are probably right. However, the manipulation aspect is definitely well researched and I'll see what I can drag up. I generally do not keep a list so I will have to see what I can get and it not available then I will have to dig some up myself-it won't be exhaustive but it will keep you busy reading the articles for a few months. The double blinds are there too. If you read the Rosner citation he gave some.

[aikidoc]

Here's one place to start:

www.fcer.org. There are a few online articles with references there. Some discuss the research efforts being put forth. If you want to spend $134 you can get access to Mantis with 71,000 references.

[aikidoc]

Erik:

That stuff is old news. Yes, the profession did not do a good job of using the study. By the way one of the people involved with Shekelle and Rand was one of my classmates.

Your comment was a low blow. I was not the one starting the criticism with no back up (other than a biased and dubious website with weak references). I was merely trying to point out the carelessness of relying on a group of zealots for sources of valid information.

Yes the chiropractic profession has its problem children and yes several make dubious claims, it's theory is weak, and we do stupid things-so do others. Many mainstream DCs think as I do and don't buy into the garbage. However, to debunk everyone and to debunk manipulation as a valid treatment flies in the face of evidence and does not present a balanced perspective. Everytime debunkers are asked to do the research they always throw it back to the people they criticize. The research is there and growing if one choses to read it. However, using debating techniques and constantly changing the arguments and throwing barbs does little for a progressive discussion.

I did not start the criticism-only responded to it. Now we seem to want to play a little game of here's more dirt. We can do that all day with little progress. If you want to be truly objective and not have a biased ax to grind read the research. It's not my responsibility to go dig it up for you. If you want to maintain your point of view-which you may still do after reading the literature that's a possible course. But at least you will have evaluated both sides of the coin.

Go ahead. Dig up more sites like that. I know they exist. I ought to do a quackbusters site on the medical profession using the same tactics-don't do much research, use only negative aspects of the research I do cite, misinterpret studies, use bad examples from the professions (MDs bury a lot more with drugs and mistakes than we do so it's a fruitful field), etc. etc. But what does that prove? I'm good at National Enquirer journalism.

Research is the basis of of progress. Problems with theory, etc are advanced through such media. Gotta do and read it though.

[aikidoc]

that I have learned of Chiropractic theory sounds as preposterous as what I know of Nephrology.

Nephrology is the study of kidneys. I'm not aware of this one.

[Bronson]

Nephrology is the study of kidneys. I'm not aware of this one.

I think he may have meant Phrenology (http://pages.britishlibrary.net/phrenology/), the study of bumps on the head.

Bronson

[Kevin Wilbanks]

Anh... phrenology, nephrology... what's the difference? On the one hand, you've got a wild-eyed guy detecting everything from disease to personality to future events by rubbing the bumps on your head. On the other hand you've got a guy who peers through jars of urine and hooks you up to a million dollar blood filtration machine. Clearly a trivial misteak.

[Kevin Wilbanks]

You seem to have funny ideas about the purpose and value of research. I would think that legitimate health care professionals would not view research as something that one drums up ex post facto to shut up the critics, it's value being measured by its bulk and quantity. Research should be a fundamental part of the process of developing therapies and procedures in the first place. You seem to be saying that you know that there are piles of research out there, but aren't particularly familiar with the substance of it. If so, what informs the decision to use a particular procedure to achieve a particular result? If it isn't dervied from the theory and isn't based on research, where do the diagnostic and treatment procedures come from? Guessing? And, if you don't believe in the theory that forms the basis of the discipline in the first place, why call yourself a chiropractor?

I looked through the retrospective on research article on the site you linked. For the most part your unsatisfying answer "we're working on it" seems to sum it up. I'm still looking for any indication that chiropractic manipulation has been shown to do anything aside from provide temporary pain relief for back pain situations... it appears that perhaps headaches and sciatica might be added to this list. Nevertheless, if all that it can legitimately offer is temporary pain relief, my critique in terms of fostering dependency and not addressing the cause of the problems stands... over the counter drugs offer pain relief at a much lower cost, and do not tend to lead customers into believing anything more than a temporary masking of symptoms is being paid for or delivered. I am also still waiting for even the most basic plausible explanation of how or why forcibly manipulating the spine could or would address the cause of any ailment.

[aikidoc]

You sure like to put words in my mouth. I never made any claims for manipulation curing diseases or creating dependency (that must come from the quackers).

I'm curious-since you seem to be such an expert on research, logic, etc. What are your credentials:

What degrees you hold and in what areas?

How many peer reviewed articles have you published and what are they are where are they-love to read them.

How many research projects have you participated in/completed.

I mean if you're a Phd or somethng, I'm out of my league here. I know, your credentials are not important-that authority thing.

By the way, your little web page on arguments-you should try applying some the the criteria to the quackers site-lots of violatons.

[aikidoc]

By the way, I have read a lot of the research but I don't keep copies of the stuff hand except in refereed journals.

Oh, I forgot. Are you editorial staff for any refereed journals?

[Kevin Wilbanks]

I mean if you're a Phd or somethng, I'm out of my league here. I know, your credentials are not important-that authority thing.

By the way, your little web page on arguments-you should try applying some the the criteria to the quackers site-lots of violatons.
Obviously you do not understand "that authority thing" at all. For the whatevereth time, my credentials, yours, or anyone's are not important. The authority of any agent or source cannot be invoked to confer truth on claims in legitimate discourse.

As far as the logic goes, I don't think one needs to study the site to see what you are doing. I've asked some pretty basic questions and made the same critical points over and over again. Either you don't understand them or have no satisfactory responses, so you continue to ply diversionary tactics and flounder over basics. For instance, the charge of fostering dependency was clearly, repeatedly mine, so saying it 'puts words in your mouth' is nonsensical.

Anyway, to wrap this up, I'd like to go back to the orginal poster's question. My interpretation was that he wanted to get some understanding of the cause of his peculiar joint problem. He did not ask for temporary relief of pain applied without a legitimate knowledge base or the possibility of a concrete diagnosis, and he did not describe symptoms suggestive of back pain, headaches, or sciatica. Hence, my initial "attack" decrying the legitimacy of recommending a Chiropractor for his problem stands.

[aikidoc]

He did not specify where his popping was. I only laid out some possibilities and suggested he seek help (preferably from someone able to pass a basic test on the musculoskeletal system).

"He did not ask for temporary relief of pain applied without a legitimate knowledge base or the possibility of a concrete diagnosis, and he did not describe symptoms suggestive of back pain, headaches, or sciatica."

I never suggested any of the statements above. Your interpretation of the quackers website and it biased literature references, personal bias from your bad experience, and leaps of logic dumping me in a category generally comprised of a minority of chiropractors with a subsequent attack on me is what led to this. Read your own website reference on faulty logic about generalizing from a minority to the whole. Your concise statment is only a slight amount of the research available.

Your points have taken a circuitous route. First you cite the quackers as an authority then you state you did not rely totally on them but you never point out your actual sources-and then criticize me for not providing you with references. Your arguments are just as weak as mine.

What you fail to realize is I don't promulgate chiropractic philosophy (there are a lot of others that don't either) of do questionable practices or marketing, I make decisions on the best clinical information available, I read the research (and the criticisms), I study medical textbooks, and I realize where the profession is at this point. However, you attacked me with little or no knowledge of what I'm about or anything about my background. You provide no support other than the quackers site and use debating tactics to avoid addressing criticisms of research on the quackers site. We can simply play this game forever. You cite everything but your opinion as being irrelevant. I'm sorry but in the academic world and the medical world-credentials are important. They establish that you have punched some tickets along the way that at least give you a foundation to base decisions and comments. It does not mean you can't still be biased but to assume they are not important is naive. Your arguments are just as weak as you claim mine to be.

I have had one other experience where I made a very innocuous statement about atemi waza in aikido and was called a fraud, threatened, etc., etc. All without any justification, knowledge of the article, or anything else. Its easy to attack without provocation or knowledge. Anyone can do it. I hope on an aikido related website, people can eventually move beyond this type of crap. It was why I stayed off the site for awhile because it got old and it detracts from civil discourse. My advice was not directed at you but rather to the poster. You, however, decided to be the crusader against me and a profession that your knowledge base seems to be limited to a site promulgated by biased zealots who have been discounted in courts of law and who use research (like the Norris article-they won't tell how they did their survey, how convenient) to serve their opinions.

I agree. Let's put this to rest.

[Kevin Wilbanks]

I don't know how you came to this chronicle of oppression and personal attack. If you read carefully, I haven't explicitly attacked you personally, or used any derisive pejorative language, whereas you have employed these tactics from the beginning.

I have criticized your performance in this argument. You have demonstrated an apparently marked lack of basic reasoning and reading comprehension skills and a reluctance to address my basic, repeated questions that borders on the disingenuous.

In retrospect, I should not have even brought up the quackwatch site, as it is peripheral to my basic points and questions and seems to have fueled much of your confusion/attempts at obfuscation.

What else can I say? I still have received no evidence of Chiropractic's effectiveness for anything beyond temporary pain relief. I still have received no explanation for how or why spinal manipulation is supposed to work, and no explanation of what the as-yet-unresearched diagnostic and treatment procedures that Chiropractors of any type use is based upon.

[rachmass]

off the current track;

my DO just prescribed that I take mangnanese for several months to help eliminate all the popping in my joints. Don't know if anyone has any experience with this. She did say not to take it over 3 months as it is potentially carcionogenic!

[aikidoc]

Really. Here's how I signed my post, right under the chiro reference you jumped on: John Riggs, D.C. You did not need to read my profile it was right there in black and white.

"I don't know how you came to this chronicle of oppression and personal attack. If you read carefully, I haven't explicitly attacked you personally, or used any derisive pejorative language, whereas you have employed these tactics from the beginning." I was not singling you out, and did not even read your profile to know you are a chiropractor." I guess "reading comprehension skills" only applies to me. Your standards seem to only go one way. I guess I was not one of the people you were referring to in the following huh?

Followed by this backhanded slap at me.

"In my view, putting any aspect of your life on hold in anticipation of the advice of a Chiropractor would be extremely foolish. The Chiro seeks to foster your dependency upon them and secure the resulting income stream as a matter of theory and policy. Don't just hand them the goods before they even get a chance to ply you with their propaganda just because a "couple of people" on the net made a suggestion ....

While the possibilities John laid out seem roughly correct." Now how would you interpret that statement. Especially tied into the above.

Love this one: "no explanation of what the as-yet-unresearched diagnostic and treatment procedures that Chiropractors of any type use is based upon." Were in trouble here. Most of us (except some fringers) use standard neurological and medical examination procedures: neurological tests (DTRs, sensory, cranial nerves, posterior column, cerebellar, pathological-e.g. dysdiadochokinesia, Babinski's, Hoffman's, Gordon's, etc.-i.e., what we are taught in school, AK is not taught-at least where I went), orthopedic tests (Patrick Fabere, Hawkin's-Kennedy, Bechterew's, Kemp's, Gaenslen's, Laseque's, Bonnet's, etc.), standard medical histories (systems reviews, past medical history), Physical examination procedures (medical)-auscultation, blood pressure, and so on. I don't know what other DCs use but these are the things we are taught in school (even back in 1985 when I went) and were considered the standard of care. Now are there other things that technique guru's use-I guess so. I don't go to their seminars so I don't know. (I did walk by a seminar where they were talking to the feet one day-pretty funny-I asked them what they were saying-my bs detector was deafening). I know the Toftness thing in the quacker site I read about it once. It was banned in California (I have a license there too) back in about the late 1950s or early 1960s yet is portrayed as standard. That's like saying the leeching MDs did in the late 1890s is a standard of care today (although they do use medical leeches for a legitimate reason today). As for muscle testing, I was only taught muscle testing for neurological levels-deltoids-C5, wrist extensors-C6, etc. (you know the stuff med students learn). So I'm not sure what you referred to-I think the AK people do some vitamin testing (pure BS) using muscles. My nutrition class in chiropractic college emphasized this was bogus and needed to be abandoned. I'm sure some still use it. Just like some MDs use unproven ozone therapy injections (fringe).

What is not clear is what your basic question/premise was in the first place. Are you trying to get me to admit that the profession has a problem with it's basic theoretical premise and the behaviors of some of it's practitioners?-if so, I concede. I've already made those concessions before. Even writers in the profession have taken on this issue numerous times. We still have a long way to go. Every profession has its problems and problem children -but generalizing them to the whole is a yellow journalism tactic.

"As a whole, the profession seems curiously uninterested in submitting their practices to even basic epidemiological analysis, much less placebo-controlled scientific testing..." Where'd this come from? Your opinion. Where's your proof? The quacker site! The statement is inaccurate if you chose to read a couple of the references (FCER site) I provided you would find considerable effort being generated (even given limited funds). One of the RAND researchers is one of my classmates and he has a PhD from UCLA in epidemiology. He primarily researchs on chipractic (Eric Hurwitz). One of the FCER references even talks about the efforts being made. The Journal of Manipulative and Physiological Therapeutics is just one example of regularly published chiropractic research-published 9 times a year. I have given you some research references. There are more if you chose to look-I know not your responsibility. Cop out.



"The Chiro seeks to foster your dependency upon them and secure the resulting income stream as a matter of theory and policy. (Who's theory and policy?-I'd like to see that written statement Or is this your personal experience with one chiro? Be nice to know where it's coming from.). Don't just hand them the goods before they even get a chance to ply you with their propaganda just because a couple of people on the net made a suggestion. There is no evidence that Chiropractic treatment accomplishes anything beyond temporary relief of back pain of certain kinds. coincidence? Its theoretical edifice has more in common with palmistry and nephrology (I think you meant phrenology) than contemporary science." This rhetoric is pretty much right from the quacker website. Now that's a reliable and unbiased source. You threw them in the mix and now you want to obfuscate their contribution to this topic by stating you wish you hadn't included them. So what are your real sources? When I analyze the quality of their references you avoid dealing with it. When I bring up questionable studies like the Norris survey on strokes (where they won't tell how the research was done, over what time frame, and what questions were asked, etc.) you avoid it. You keep asking me to back my statements up yet you are not held to the same standard. How convenient.

I have criticized your performance in this argument(that you have and when I give you some of the same back you just turn it around-using a website which when I criticize the quackers for using you avoid addressing it). You have demonstrated an apparently marked lack of basic reasoning and reading comprehension skills and a reluctance to address my basic, repeated questions that borders on the disingenuous. What repeated questions? The only thing you keep asking me to do is provide you with the research. What you don't realize is what a daunting task that is since there is a lot of research going on and published on the topic-maybe I need to subscribe to Mantis to download it but it would be wasted since you would probably want me to summarize it for you and then criticize my summary as biased.

You avoid providing me with anything other than your opinion, hold me to a higher standard and I'm disingenuous! I guess unless it is coming from you it is all irrelevant-no proof or legitimate sources required since you are the one doing the attacking.

[Kevin Wilbanks]

It seems like you are getting more emotional and less coherent with each successive post. In my experience getting too worked up about a net exchange is very unpleasant and unhealthy, and leads me to back off and re-evaluate the whole situation. I've found that getting highly upset at someone I've never met and likely don't care a whit about when it comes down to it is a very perplexing phenomenon - one that leads me to wonder what is cause and what is symptom.

Your interpretation of my first volley is downright paranoiac, and your overall tone and vocabulary is growing moreso. I did not see the DC by your name and the comments about chiros were general. Subsequent critical comments about chiropractic theory and practicioners were only meant to apply to you if they happened to.

I find it difficult to respond to the substance of this post because it seems to be a bit of morass. The thinking problems continue:

In order to invalidate my "no evidence" claims you have but to produce one study, not all of them - this is basic logic. Providing a list of journals is no more valid a counter-argument than providing the address of a local research library. If there are so many, I don't see the difficulty here. If you have some explanatory grasp of how manipulation works and why it is used to treat ailments, I don't see the difficulty in conveying that either. If I asked a cardiologist the same questions about the practice of prescribing beta-blockers, I'd have simple, swift answers.

Cataloging the references of Quackwatch and casting aspersions on their authoritativeness does not constitute a critical review of sources, explaining the errors in the source material itself does. If you have the time, be my guest, but it is not my site, and I am not their official apologist.

It's nice to know a list of diagnostic procedures, but it is not an explanation of how one leaps from them to cracking someone's back as a treatment. If the link from diagnosis to specific prescription is not based on research and not derived from theoretical dogma, I still don't see what could be left but guessing.

Finally, the notion that we have equal burdens to produce evidence is still absurd, both logically and situationally. Skepticism needs no proof, truth claims do. Situationally, I am not a professional anti-chiropractic skeptic and I do not charge high fees to provide chriopractic-doubting services, therefore the burden of proof cannot be similar.

[aikidoc]

Wow! Parnoid and overemotional. My friends and people who know me will get a chuckle out of that. I'm actually pretty laid back and non-emotional. I have at times been described as intense however. Obviously, I have my hot buttons.

"Your interpretation of my first volley is downright paranoiac, and your overall tone and vocabulary is growing moreso. I did not see the DC by your name and the comments about chiros were general."

Although I do not see how it could be missed since you read so thoroughly, if it's accurate then I owe you an apology.

"Subsequent critical comments about chiropractic theory and practicioners were only meant to apply to you if they happened to."

Didn't get that from your comments. I interpreted it as a condemnation of anyone associated with the profession. Your subsequent statements ostensibly did not convince me otherwise. Even the quackers conceded in their chiropractic news-The Chiropractic Coalition -- founded in November 2002 by the International Chiropractors Association, the World Chiropractic Alliance, and the Federation of Straight Chiropractors and Organizations. . . represent practitioners who espouse chiropractic's original premise that subluxated spinal bones are the primary cause of ill health. About 10% of chiropractors belong to one or more of them. Your original cricitsms apply to this group-they are the ones making claims about curing everything but the common cold with manipulation. And seem to be frequently involved in questionable practices, although not exclusively.

I never made claims about manipulation treating ailments. My only contention is pain. Although there are studies evaluating such areas, few are conclusive. As to the detailed workings as to how manipulation works, there are several ongoing studies, these I don't keep at hand since, I'm sure as a cardiologist cannot do, I am rarely asked by patients to provide a detailed explanation of why the procedure works. I'm sure the cardiologist will know the effects of medications and the intended action but few are likely able to provide information on the detailed pharmcological aspects or the research studies-just too much detail and not enough time for active practitioners. I do know that research at a minimum supports joint cavitation having an affect on nociceptors (pain) and restoration of motion in hypomobilities. It is also known to break adhesions (a good example is a frozen shoulder-usually manipulated under anesthesia (hospital or surgical center) due to pain (I received training in MUA but don't practice it). Currently, manipulation studies are controversial in several aspects-mostly due to research flaws in not only supporting but non-supporting research. That's why it's research and ongoing. Many surgeons do not have detailed research backing up why excising works either, or why as in the case of back surgery 30-40% failure rates are not uncommon.

[aikidoc]

Rachael:

To answer your question, I did a Medscape/Medline search and didn't turn up anything on the joint popping and manganese. As the the carcinogenicity issue here is one article reference:

Manganese deficiency and toxicity: are high or low dietary amounts of manganese cause for concern?

Biofactors 1999;10(1):15-24 (ISSN: 0951-6433)

Finley JW; Davis CD

United States Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, ND 58202-9034, USA.

Manganese is an essential trace element that is required for the activity of several enzymes. Manganese is also quite toxic when ingested in large amounts, such as the inhalation of Mn-laden dust by miners. This review examines Mn intake by way of the food supply and poses the question: Is there reason to be concerned with Mn toxicity or deficiency in free-living populations in North America? Although much remains to be learned of the functions of Mn, at present there are only a few vaguely described cases of Mn deficiency in the medical literature. Given the heterogeneity of the North American food supply, it is difficult to see the possibility of more than greatly isolated and unique instances of Mn deficiency. However, low Mn-dependent superoxide dismutase activity may be associated with cancer susceptibility, and deserves further study. There may be reasons, however, to be concerned about Mn toxicity under some very specialized conditions. Increasing numbers of young people are adopting a vegetarian lifestyle which may greatly increase Mn intake. Iron deficiency may increase Mn absorption and further increase the body-burden of Mn, especially in vegetarians. Mn is eliminated primarily through the bile, and hepatic dysfunction could depress Mn excretion and further contribute to the body burden. Would such a combination of events predispose substantial numbers of people to chronic Mn toxicity? At present, there is no definite proof of this occurring, but given the state of knowledge at the present time, more studies with longer time-frames and more sensitive methods of analysis are needed.

Hope it helps. There may be something with regards to the joint popping-didn't see it. Maybe I formulated the search wrong.