September 2002 Issue

In this issue:


Study Shows Chiropractic Technique Effective In Breech Turning

A study published in the July/August 2002 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) shows that a chiropractic technique known as the "Webster Technique" for managing the musculoskeletal causes of intrauterine constraint, is effective in cases of pregnancy with women experiencing breech presentation which can lead to a cesarean section birth.

According to the published study, "Intrauterine constraint is defined as any force external to the developing fetus that obstructs the normal movement of the fetus." Intrauterine constraint can prevent the developing fetus from moving into the normal head-down position needed for a normal vaginal birth. When this happens this is called a "breech presentation".  This situation plays a critical role in how the mother delivers her baby.  According to the statistics published in the article, in the United States 86% of all infants with breech presentation are delivered by cesarean section.

According to the JMPT article, the Webster Technique is a chiropractic technique designed to relieve the musculoskeletal causes of intrauterine constraint. This technique is also known by names such as as Webster's In-Utero Constraint Technique or Webster's Breech Turning Technique.  The Webster Technique was developed by Dr. Larry Webster in 1978. Dr. Webster was often referred to in the Chiropractic profession as "The Grandfather of Chiropractic Pediatrics."  Additionally, the technique is presently taught in many chiropractic colleges and postgraduate chiropractic education seminars.

The study was done by surveying a large number of doctors of chiropractic who use the technique to see the percentage of results they obtain on real patients. The survey required detailed information to verify the accuracy of the responses. The results showed that 82% of the doctors surveyed reported a high rate of success when using the Webster Technique.  The results from the study suggested that it may be beneficial to perform the Webster Technique in the 8th month of pregnancy, if it has been determined that the child is in the breech position.  This timing is important because from the 8th month on, a breech presentation is unlikely to spontaneously convert to the normal head down position. 

The study concludes by saying, "when successful, the Webster Technique avoids the costs and risks of cesarean section or vaginal trial of breech. In view of these findings, the Webster Technique deserves serious consideration in the management of expectant mothers exhibiting adverse fetal presentation."


Study Says Nerve Blocks, Don't Reduce Pain, Improve Mood or Cut the Use of Analgesic Medications

In the Reuters Health News August 20, 2002 issue is a story reporting on a study that says nerve blocks do not do what they are supposed to do to reduce pain or improve the quality of life.  According to Steven H. Sanders, program director in the psychology department at the Siskin Hospital for Physical Rehabilitation in Chattanooga, Tennessee, nerve blocks are often recommended for both acute and chronic low back pain, but long-term studies of the blocks are scarce.  Dr. Sanders said, "We wanted to see whether (the blocks) made any difference." 

To check the validity of this common procedure, Dr. Sanders and his group evaluated two groups: 30 patients with low back pain who received the blocks and 30 with low back pain who did not. The nerve blocks, more specifically called lumbar sympathetic nerve blocks,  are injected into the area surrounding sympathetic nerves in the lower back. Most contain either local anesthetic or local anesthetic with corticosteroid drugs. To help assure that the results were accurate, both groups of patients had the same treatment except for the nerve blocks.  The patients that got the nerve block had three to six blocks performed. The subjects in the block and non-block groups were matched as far as age, gender, duration of pain (which ranged from 2 to 4 years) and previous back surgery. The patients ranged in age from 43 to 56 years.

The results at the end of 6 months showed that the patients who received nerve blocks did no better than those who did not get nerve blocks in terms of pain, reduced use of pain medication, mood and other issues. The blocks did increase the treatment costs from an average of $4,500 per patient in the group without nerve blocks to $5,900 for the patients who got nerve blocks.  In light of these results Dr. Sanders comments were that he felt these procedures represented, "a lot of expense, but no clinical benefits. You have to wonder why you do these (blocks)."


Chiropractic Advisory Committee Named by U.S. Department of Veterans AffairsSeal of the Department of Veterans Affairs

It took an act of the US Congress, but the Department of Veterans Affairs (DVA) has finally taken steps toward offering chiropractic care to all US military and veterans. The first step involves the creation of a committee to oversee and make recommendations to the DVA on how best to offer chiropractic care to all their beneficiaries.  As was reported in the August 8, 2002 issue of the Chiropractic News Service, as well as most every other chiropractic publication, the five member Advisory Committee was made up of representatives from most national chiropractic associations.

Initial indications are that the Chiropractic Advisory Committee will have at least three meetings in the coming year, based on budget information the DVA has provided. "We are pleased to finally see some movement on this vital new chiropractic program," said International Chiropractors Association President Dr. D.D. Humber. "We continue to have concerns, however, over the delay in taking this first step of naming Chiropractic Advisory Committee members and what it might mean for the rest of the process. We will urge the chiropractic representatives of this committee to come together and aggressively assert the rights of veterans to receive the chiropractic services mandated by Congress, without obstruction or unnecessary delay on the part of the DVA."

Among the key issues which this Advisory Committee will deal with will be direct access to chiropractic care, a vital component of any benefits program and one of the top priorities in this and in all health benefits programs, both public and private. Most of the chiropractic profession is concerned that the DVA will attempt to limit the access of chiropractic care, placing the benefits under the direct referral of medical doctors.   The chiropractic profession and the national associations are unanimous in their objection to any provision that would limit the rights of US veterans to have direct access to chiropractic services when they desire them.

The wording of the bill that requires chiropractic care to be offered by the DVA includes the following. "The program shall be carried out at sites designated by the Secretary for purpose of the program. The Secretary shall designate [at least] one site for such program in each geographic service area of the Veterans Health Administration. The sites so designated shall be medical centers and clinics located in urban areas and in rural areas. The chiropractic care and services available under the program shall include a variety of chiropractic care and services for neuro-musculoskeletal conditions, including subluxation complex."


Cholesterol Drugs Have Problems

In a series of recent separate stories two popular cholesterol drugs have had significant problems that have caused one of them to be removed from the market and the other to draw news story warnings.  From the August 8, 2002 issue of USA Today comes a story that starts off by stating that drugs that lower cholesterol may cause nerve damage.   In a new study, Danish researchers say these drugs, called Statins, raise a person's risk of nerve damage by nearly 15%, or roughly one case for every 2,200 patients age 50 or older.  

Lead author David Gaist of the University of Southern Denmark conducted the first large-scale study to link the drugs with nerve damage, which is marked by weakness, tingling, difficulty walking and pain.  The study shows that the longer patients took the drugs, the more likely they were to suffer nerve damage.

Currently it is estimated that about 16 million Americans take statins such as Lipitor and Pravachol.  The Danish study drew only limited coverage in the United States.  However, one researcher from the US agrees with the alarm.  "We should definitely sit up and take notice," says Beatrice Golomb, an assistant professor of medicine at the University of California, San Diego, who heads a federally funded study of the effects of statin drugs on thinking ability, mood and quality of life.

This new information comes almost exactly one year after Bayer pulled their statin drug off the market. A year ago, the statin drug known as Baycol was recalled after health officials linked the drug to more than 100 deaths worldwide from a rare muscle condition. No deaths have been reported from the newly discovered nerve damage in this study.


Chiropractic Story Worth Telling

From the August 3, 2002 issue of the Los Angeles Daily News comes an uplifting story that has been labeled by the paper as, "A Miracle on Hortense Street. The story is of 10-year-old, Laura Bibb, a developmentally delayed girl, who as the newspaper reported, "went from being the neighborhood pity to the neighborhood Rocky." As a baby, Laura was initially diagnosed as being mildly mentally retarded. Later, when it came time for her to start school, her skills and test scores placed her at the severely retarded level.

Helen and Ron Bibb, Laura's parents, never gave up hope or stopped fighting for their daughter. Helen spent half her life on the Internet looking for the answers to why Laura's body had betrayed her. Laura kept falling down, she would also start to binge-eat and sometimes refuse to talk to her family for long periods of time.

Neither the Internet nor her doctors could give Laura's mom Helen the answers.  The medical doctors were saying that everything medical science had to offer, inside the confines of an HMO plan, was being done to help.  "I was on the diagnosis merry-go-round, going nowhere," Helen says. "There were plenty of explanations and excuses, but no answers."  She continued, "She had orthotics put in her shoes, but her knees were still swollen and getting worse.  Her right leg and foot were starting to turn in. The orthopedic doctors suggested knee braces and painkillers."

Then one day, a neighbor of the Bibb's, Pam Flynn, wrenched her knee and went to see Toluca Lake chiropractor, Dr. King Rollins.  While under care, she told the chiropractor about 10 year old Laura.  She mentioned that Laura was falling down all the time, and would soon need braces and a steady diet of painkillers just to get around. "The idea of this wonderful little girl who had already been through so much, now needing braces to walk really threw me," Pam said. Later that day, Pam went to see Helen and told her to see the chiropractor who she said also treated kids.  Pam told Helen, "Go see him, what could it hurt?"

That's exactly what Helen Bibb did as she brought Laura to see the chiropractor.  And the results were miraculous!   Dr. Rollins commented on his care for Laura by saying, "I was looking for anything that would interfere with Laura's nervous system, and I found a vertebra at the base of her skull was way out of place and putting pressure on her nerves," he said. "So I adjusted it." 

Laura's mom Helen thought the procedure was so simple, yet the results were so profound.  "The first thing Laura did was let out a big sigh of relief," Helen said. "That night she came down the stairs by herself.  We were stunned. This used to take forever with Laura holding on to both rails, her dad in front so she wouldn't fall, and me guiding from behind.  Laura now wants to move and run and be a real kid for the first time. All the doctors said that her foot would stay turned in and there was nothing they could do. Well, her foot has straightened out, too."

The Bibb's neighbors noticed the changes as well. One of them Elaine Alexander commented, "She's an entirely different little girl, mentally as well as physically.  She used to be shy and hide behind her mother. Now, she's in the open, talking."

The LA Daily News story further reported that the girls life was changed when this summer, Laura did something Helen, in her most optimistic dreams, never would have thought possible. With her mom and dad, younger sister Julie, and older brother Edward cheering her on and bursting with pride, Laura swam with the dolphins at Sea World.  Laura's mom Helen concluded the article by saying, "When we'd walk the dogs, Laura couldn't keep up. Now, she's out front. It's been a remarkable transformation.  Look at her, she's so proud of herself."


White House Commission Final Report

In March of 2000 the White House issued  Executive Order No. 13147 which initiated the White House Commission on Complementary and Alternative Medicine ("CAM").  The commission was designed to, for the first time, look into non-medical health care.  The commission called all such care Complementary and Alternative Medicine (CAM) even though most all the forms of health care included in this category were not alternatives and certainly not medicine in any form.  Chiropractic was one of the CAM healthcare delivery systems included in the report. Chiropractic represents the largest of the professions that fit into the CAM category and the only profession in the group whose practitioners are doctors who are licensed in all 50 states.

In March of 2002 this Commission released its final report. The Executive Summary of the report, published on their web site at http://whccamp.hhs.gov/, contained 10 recommendations to be included into the final report. These ten speak to very important and fundamental issues in health care. They are listed below.

  1. A wholeness orientation in health care delivery. Health involves all aspects of life-mind, body, spirit, and environment-and high-quality health care must support care of the whole person.
  2. Evidence of safety and efficacy. The Commission is committed to promoting the use of science and appropriate scientific methods to help identify safe and effective CAM services and products and to generate evidence that will protect and promote the public health.
  3. The healing capacity of the person. People have a remarkable capacity for recovery and self-healing, and a major focus of health care is to support and promote this capacity.
  4. Respect for individuality. Each person is unique and has the right to health care that is appropriately responsive to him or her, respecting preferences and preserving dignity.
  5. The right to choose treatment. Each person has the right to choose freely among safe and effective care or approaches, as well as among qualified practitioners who are accountable for their claims and actions and responsive to the person's needs.
  6. An emphasis on health promotion and self-care. Good health care emphasizes self-care and early intervention for maintaining and promoting health.
  7. Partnerships as essential to integrated health care. Good health care requires teamwork among patients, health care practitioners (conventional and CAM), and researchers committed to creating optimal healing environments and to respecting the diversity of all health care traditions.
  8. Education as a fundamental health care service. Education about prevention, healthy lifestyles, and the power of self-healing should be made an integral part of the curricula of all health care professionals and should be made available to the public of all ages.
  9. Dissemination of comprehensive and timely information. The quality of health care can be enhanced by promoting efforts that thoroughly and thoughtfully examine the evidence on which CAM systems, practices, and products are based and make this evidence widely, rapidly, and easily available.
  10. Integral public involvement. The input of informed consumers and other members of the public must be incorporated in setting priorities for health care and health care research and in reaching policy decisions, including those related to CAM, within the public and private sectors.

From a chiropractic standpoint, it is good to see these ten points being brought forth in such a public document. Many of these statements by the Commission regarding wholeness, healing, wellness, and the right of the individual to choose their form of health care have been part of chiropractic practices for decades.

The commission recognized the ever-growing role that non-medical care is having on the population in the United States. In concluding they made the following statement, "The Commission recommends that the President, Secretary of Health and Human Services, or Congress create an office to coordinate Federal CAM activities and to facilitate the integration of safe and effective practices and products into the nation's health care system."


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