Chiropractic

[Mr Skeptic]

I had a "frozen shoulder" develop in this way after a Supraspinatus muscle tear, and it took about 3 months of very painful exercises to recover full mobility and function.

 

Could you tell me more about this frozen shoulder thing? My brother has a problem with his arm that nobody knows anything about.

[Psyber]

Could you tell me more about this frozen shoulder thing? My brother has a problem with his arm that nobody knows anything about.

Sure. Essentially, I tore a muscle in my left shoulder and found it hurt quite severely if I made certain movements, like pulling my car into second gear with the 4 on the floor configuration. Fortunately, it was a hefty V8 so I simply went 1st to 3rd. Similarly because I am strongly right handed it was not great hardship to me to use my right for everything and brace my left arm to my body to minimise movement and pain. After a few months of this despite ultrasound treatment from a physio I discovered that if I moved the shoulder more than about 20mm in any direction it hurt like Hell. Time to seek other help! I pressed the point that passive treatment was not working, and got referred to an occupational and rehabilitation physician.

 

After X-rays etc to check there was no actual damage to the bones and joints and that the problem was just that the muscles had shrunk and contracted, it was time to start exercises to stretch and mobilise them. This hurts like Hell because you have to at a microscopic level tear muscle fibres where they are stuck down and stretch them. So for the next 3 months it was move the arm forward until you are gritting you teeth to bear the pain, then push it a few more millimetres, rest a few moments and do the same backwards, rest more then do it sideways. A few millimetres at a time you restore mobility and function. It has been fine ever since - that was some years ago.

 

Most musculo-skeletal injuries are soft tissue injuries - not damage to bones, joints, disks. However, because Medicare in Australia will not fund early MRI scans to determine this, doctors and patients, not wanting to cause more harm, play safe and treat everything as serious injury in case of such hard tissue damage, and this gives muscles time to shrink. So the original injury may have healed but the pain goes on and everyone assumes it is the original injury unhealed.

 

Basically, if serious bone, disk and joint damage can be ruled out the basic need is to keep using the muscles no matter how much it hurts and it will get better.

[Realitycheck]

Yeah, shoulder injuries can get pretty complicated since there is little supporting structure, mostly just soft tissue supporting everything from many different angles. When you injure one muscle, it tends to make others spastic and problematic, as well.

 

It is important to get an MRI to find out exactly what is going on. The chiros thought that I had frozen shoulder, when in all actuality it was nerve damage preventing me from using those muscles. The chiros just wasted precious time in treating it.

[Mr Skeptic]

Thanks Psyber. My brother's problem seems to be nerve related, but the doctors have been sending him every which way to get tests and stuff for half a year already, and so far they suggest an "ignore it until it goes away" approach. He can't lift his right arm past horizontal, and by now the muscle responsible has atrophied. It makes me mad, and I think his insurance is trying to bail out/drag their feet on this one.

[Realitycheck]

If it is truly frozen shoulder, it is supposed to be really clamped down, hardly moving at all.

[Psyber]

Thanks Psyber. My brother's problem seems to be nerve related, but the doctors have been sending him every which way to get tests and stuff for half a year already, and so far they suggest an "ignore it until it goes away" approach. He can't lift his right arm past horizontal, and by now the muscle responsible has atrophied. It makes me mad, and I think his insurance is trying to bail out/drag their feet on this one.

That sounds more like sub-acromial impingement, but it could be weakness in the muscles lifting the shoulder blade due to a neck problem. He should request referal to an Occupational Physician or a Rehabilitation Physician - the terms vary from place to place and they aren't easy to find because it is not a big specialty.

 

The muscles attaching the arm to the shoulder lift the arm to horizontal but if scarred they may jam between two bony surfaces before you get that far and the shoulder blade movement which is usually involved to lift the arm above the shoulder has to kick in sooner - but that then limits how high you can go. A clicking sensation associated with pain when raising the arm straight and laterally - outwards - usually points to sub-acromial impingement.

[John F]

To ecoli

 

Plenty of research has already been done on the value of chiropractic treatments. The result = zero.

 

I went to a lecture by a doctor who had practised chiropracty once. This guy was a fully qualified general practitioner, and decided to extend his field. he did the full training course to make him a qualified chiropractor, and began his chiropractic work.

 

He started getting suspicious when he found that all his 'massages' worked equally well. When a patient with a shoulder or neck ache was given the treatment for lower back pain, it worked just as well as when he gave the proper treatment. He also discovered that the results appeared to correlate with noise. The louder the pop, the better the result. After all this, he concluded that the effect was pure placebo, and he gave it away.

 

If you want further information, try http://www.quackwatc...pics/chiro.html

 

I don't believe you have looked at any of the chiropractic research. Plenty of research has shown chiropractic to be one of the most effective procedures of a number of conditions. http://www.acatoday.org/pdf/acaefficacy2008.pdf,

[jimparter]

I don't believe you have looked at any of the chiropractic research. Plenty of research has shown chiropractic to be one of the most effective procedures of a number of conditions. http://www.acatoday....fficacy2008.pdf,

I am suffering from some mouth injury problem I want to know Chiropractic treatment is successful in this case or not.I am going with my dentists Mechanicsburg PA Dentists

Please reply me.

[Moontanman]

I am suffering from some mouth injury problem I want to know Chiropractic treatment is successful in this case or not.I am going with my dentists Mechanicsburg PA Dentists

Please reply me.

 

 

Jim, please do not go to a chiropractor, if your problem is real go to a real doctor.

[Marat]

But let us suppose that chiropractic treatment operates entirely via the placebo effect, but that the only or the most effective way to achieve this placebo effect is through the physically ineffective rituals of chiropractic. Obviously if someone just says 'Abracadabra, your pain is gone!' that will not work to induce the placebo effect in a modern person, who requires some ritual which at least looks scientific before his mind can be engaged to heal his body. So chiropractic may be 'valid' at least in the sense that it does quite effectively incorporate all the pseudo-scientific rituals and trappings necessary to induce modern, educated people to think it is effective, and it does indeed have a phenomenologically 'real' placebo effect which not going to a chiropractor would not have.

 

So chiropractic does accomplish something.

 

Alternatively, I wonder what people think of a related treatment by doctors of osteopathy? In many jurisdictions they enjoy almost the same medical practise rights as ordinary MDs have.

[SMF]

Marat. There is a recent research article that checked whether the placebo effect would work if the patient was informed that they were taking a placebo that had no known health effects at all, and it still worked as good as the uninformed placebo control. I heard this on NPR so it shouldn't be hard to find. I find this to be bizarre and can hardly wait to see how this issue comes out. What if all it has to do with is a little attention from someone who is sympathetic and helps the patient focus on their problem in a less reactive mode? There has been a lot of recent research on the placebo effect and ways to use it in therapy should soon be available. SM

Edited January 23, 2011 by SMF

[Marat]

This was essentially what Anton Mesmer was doing in the late 18th century with his 'magnetic' therapy, which by an elaborate ritual which his patients believed involved electricity and magnetism, actually produced genuine cures by mobilizing the self-healing capacities of the human body through a strong placebo effect. One of his patients treated in Vienna, Madmoiselle de Paradies, was blind prior to treatment and became able to play the piano afterwards (was the case perhaps one of hysterical blindness?). While what Mesmer was doing seems to have been similar in some ways to modern medical hypnosis, I wonder how important the actual rituals were to achieving his effects? It seems that all sorts of primitive cultures have similar healing practices, and always some actual activity is required to induce the expectation of a cure occurring.

[SMF]

The question is-- Have any of the nontraditional therapies, for which there is no known mechanism to explain how they might cure an organic condition, or the mechanism is just magical thinking (e.g. Homeopathy or acupuncture), been shown by a reliable scientific trial to be effective? SM