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No-Touch Chiropractic

Some time ago, I learned that a Seattle chiropractor, Johanna Hoeller, had been featured on a local TV newsmagazine show. She was so proud of the segment that she had it posted on her web page for all to see. Unfortunately it is no longer there, so I’ll have to tell you what it showed.

She demonstrated her techniques on-camera. She put one wrist on top of the other, held them about an inch away from the patient’s neck and proceeded to produce a cracking sound in her own wrists without touching the patient in any way. The patient claimed to have felt something and to have experienced relief of pain.

The funniest part was when the news crew showed her their video of her performance and pointed out that she had not touched the patient. She appeared to be surprised and responded, “My whole thing is that I’m touching.”

Hoeller practices a form of chiropractic called NUCCA (National Upper Cervical Chiropractic Association). It’s a variant of the hole-in-one idea first proposed by B.J. Palmer, the son of the inventor of chiropractic, D.D. Palmer. Supposedly if you adjust the top cervical vertebra, that will correct any problems in the entire spinal column. Fix one and you fix them all. There is no credible evidence for any of NUCCA’s claims.

So here’s a woman “pretending” to do something that doesn’t work even if you actually “do” it. A little knowledge of psychology easily explains why she has so many satisfied patients. It’s even easy to understand how her experiences may have genuinely convinced her she is doing something effective. What I have trouble imagining is how she first got the idea to try treating without touching in the first place!

I thought this was something the Washington State Chiropractic Quality Assurance Commission should know about, so I reported it to them. I pointed out that state law lists specific techniques approved for use by chiropractors: NUCCA is approved, but no-touch methods are not. If she claims to be treating with NUCCA, she is charging patients for a treatment she did not provide. If she claims to be treating with her own new method, she is using an unapproved method which is not allowed by state law. More importantly, she says she thinks she is touching when she isn’t, indicating that either (1) she is lying, or (2) she is delusional and should have a psychiatric evaluation.

The QAC evaluated my complaint by holding a telephone conference call and deciding not to investigate. They interpreted the video as a dry-run demonstration of what she would do by actually touching the patient.

I filed a second complaint, asking them to reopen the case, and they did. I asked them to view the video again because it clearly showed that she was demonstrating her actual technique, and that she said she thought she was touching when she clearly wasn’t. They still refused to act, because she hadn’t harmed any patients and they apparently thought what she was doing was OK.

I wrote some angry letters to state officials. I asked, if she can pretend to do chiropractic without touching, can I pretend to take out an appendix without touching? If so, there might be a lucrative career in my future. No one answered.

I contacted a professor of chiropractic who claims to be spearheading a reform movement within chiropractic. He was appalled, and brought the case to the attention of a national chiropractic QA organization, hoping they might put pressure on the Washington QAC. Nothing happened.

In September 2007, the Washington QAC finally took action against Hoeller for unprofessional conduct. Allegations include failing to keep adequate treatment and diagnostic records of patients, failing to re-examine a patient after treatment and failing to document a care plan for a patient. They said nothing about her no-touch techniques.

In other words, they didn’t care whether she deceived patients with imaginary hocus pocus as long as she followed them up and kept records of her deceptions.

I wonder… if I had a patient with abdominal pain and I pretended to fix something inside by waving my hands over him, followed him up to document that his pain resolved, and kept meticulous records, could I get away with it? I hope not, but now I’m beginning to wonder. It seems the state of Washington approves of voodoo medicine.

Posted in: Chiropractic, Politics and Regulation

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32 thoughts on “No-Touch Chiropractic

  1. DavidCT says:

    Where did Dr. Hoeller come up with the idea of no touch therapy? How about Theraputic touch or Reiki which are now being allowed along side of real (evidence based) medicine in a growing number of hospitals. Dr. Heoller’s therapy is just one of many woo based treatments which are gaining wider acceptance by being offered in medical school integrated medicine programs. And why not offer the treatments – there is less overhead and no insurance forms to fill out. Does anybody care about the patient? Certainly not the regulatory agencies.

  2. Deetee says:

    This illustrates the problem that exists with “self-regulation” of alternative therapies. Practitioners know that having an umbrella organisation or “society” or “council” lends them some authority in the eyes of the public. The public, naturally enough, presume that these councils regulate the practitioners, and the councils are complicit with practitioners in decieving the public as to their true function. This function is actually to promote the therapy, rather than monitor and regulate practitioners.

    This has been demonstrated repeatedly, not only with chiropractic as the article illustrates, but other therapies like homeopathy (cf the “Society of Homeopaths” in the UK). Alerting these regulatory bodies about practitioners who breach their putative “codes of practice” is about as likely to have a positive result as is taking a homeopathic antimalarial remedy to “fill the malaria-shaped holes in your body’s energy”.

  3. Joe says:

    Proponents of licensing for sCAM artists argue that the ensuing regulation would protect the public. This is an illustration that, in fact, licensing protects the practitioner because the lunatics are in charge of the asylum.

    In a related example, in Utah (which licenses naturopaths) an unlicensed naturopath treated a woman with cancer, of course she died. He was arrested for practicing medicine without a license. His lawyer said “If Utah would give the guy a license, he would not be in trouble.” I thought that profound- if the naturopathic board were behind him, he could do the same thing with impunity. (Of course, he could still be subject to a civil suit.)

    As I recall, the original video of the non-touch chiro was pulled from the web. However, I may be able to find an archived copy to link here, later.

  4. mjranum says:

    I’m sure that the Washington State Chiropractic Quality Assurance Commission was shying away from establishing a precedent that it was not OK to do nothing and still take the patient’s money. If they established such a precedent, they’d be pretty much slashing their own throats, wouldn’t they? I wonder if they consulted an attorney…

    Another possibility was simple conflict-avoidance. My experience is that a lot of consortia of practitioners are close-knit and collegial (or highly political!) and something like disciplining a member will produce repercussions lasting for years. That’s still no excuse.

  5. Joe says:

    Apparently Deetee’s comment was held for moderation, it was not visible when I posted my comment. Sorry for the overlap.

    I could not find the original, high-quality video. In it, it was quite clear that Hoeller had no physical contact with her customer. I found a poor-quality, archived video:
    http://web.archive.org/web/20051211174451/www.nuccainseattle.com/video/king5_100.wmv

    One can still get the impression that she is not touching the guy since he neither moves nor reacts when she moves her hands.

  6. humgums says:

    I am certainly not being an apologist for Hoeller’s techniques or the Washington Chiropractic QAC (I believe this is pronounced “quack”). However, it is apparently quite common for state licensing boards to bring charges of technical violations (e.g. failing to keep adequate treatment and diagnostic records of patients, failing to re-examine a patient after treatment and failing to document a care plan for a patient) against a miscreant while skirting the deeper issues. I am told the reason for this is that it is easier to make these technical charges stick, as they are more or less black & white issues. If allegations are made involving actual treatment/outcomes they can be subject to interpretation and will inevitably result in a trial which is messy and expensive.

  7. Zetetic says:

    DavidCT: Some health care organizations, particularly those with all inclusive health plans, tolerate CAM practices as a method to reduce visits to clinics for minor ailments. If the placebo effect of CAM can be applied to people who are not really sick in a controlled environment, health care delivery costs are reduced. Lower paid CAM providers within the system can also effectively screen those who have real problems and refer them to medical providers as necessary. The real problem with CAM is that some seek that sort of treatment exclusively when they really need effective science based medical treatment.

  8. Joe says:

    Zetetic wrote “Lower paid CAM providers within the system can also effectively screen those who have real problems and refer them to medical providers as necessary. The real problem with CAM is that some seek that sort of treatment exclusively when they really need effective science based medical treatment.”

    No, CAM providers are not able to “screen those who have real problems.” Your second sentence acknowledges this- if sCAM providers could screen their customers, they would not provide exclusive “treatment” to those who need medicine.

    Chiropractors (the topic of this entry) claim to be well-educated in diagnosis; but the vast amount of time they spend in school on finding subluxations does not count (because chiro-subluxations do not exist). In the end, they can graduate and get a license to practice without ever diagnosing an illness. Their “clinical” experience is often limited to young, healthy friends and family whom they can cajole, or bribe, to show up at their clinics to meet the quota of people they must examine. One cannot say the same for licensed MDs.

  9. joel_grant says:

    This topic leads me to ask a fundamental question. Dr. Hall writes:

    “I pointed out that state law lists specific techniques approved for use by chiropractors: NUCCA is approved, but no-touch methods are not. If she claims to be treating with NUCCA, she is charging patients for a treatment she did not provide. If she claims to be treating with her own new method, she is using an unapproved method which is not allowed by state law.”

    I am genuinely curious to know why chiropractic itself is legal? Are chiropractic’s central claims scientifically proven?

  10. Harriet Hall says:

    Unfortunately, legality and scientific credibility are unrelated. Both chiropractic and homeopathy originated in a pre-scientific era and accidents of history have perpetuated them.

    Chiropractic’s central claim is that “subluxations” cause nerve interference and that spinal adjustments relieve the interference, allowing the vitalistic Innate to help the body heal itself. None of this is backed by credible science. Chiropractors do have practical skills in spinal manipulation therapy, which is a viable option for some kinds of back pain, but MDs, DOs and PTs can also offer SMT.

    If you want to know more about chiropractic, I can recommend an excellent book – “Inside Chiropractic” by Samuel Homola. A lifelong chiropractor (now retired) he limited his practice to rational short-term treatment of musculoskeletal problems, and he wrote an expose of all the questionable practices of his colleagues, speaking from inside knowledge.

  11. Blue Wode says:

    ‘Dr’ Hoeller attempts to justify her technique here:
    http://www.drcat.org/articles_interviews/html/johanna.html

    “Although my hands usually pop and I sometimes grunt at the point of exertion, I don’t twist and pop the patient’s body in any way. I don’t apply excessive force, because any excess force that goes in would have to come out somewhere, based on the laws of physics. Therefore, I only apply the amount of force necessary to move the structure. Because I’m using a lever system, the actual force required is very minimal…..Most people can understand the concept of NUCCA work, but they sometimes have trouble with the lightness of the correction. The adjustment itself is so gentle that some people don’t get that anything happened.”

    Having seen the original video, I have trouble with “the lightness” of her corrections too. They’re a pretence.

    With regard to the regulatory bodies which are supposed to protect patients from this sort of thing, they tend to be a joke. For example, here in the UK one of the main duties of the chiropractic regulatory body, the General Chiropractic Council, is to ‘promote the profession’ and so far it has seen the touting of cherry-picked research, the issuing of emotive press statements rebutting negative media coverage, and the publishing of patient information literature littered with weasel-words. And the MHRA (Medicines and Healthcare products Regulatory Agency) isn’t much better. It recently licensed homeopathic products “in order to protect the commercial interests of the homeopathic industry”.

    How much further can standards slip?

  12. Zetetic says:

    Joe: I agree with you points but a CAM provider working within a health care organization in the United States is in a different position than an independent provider. I know of a few hospitals in the U.S. that employ nurses and assistants to perform CAM practices as an adjunct to conventional medical care. These organizations have realized that CAM is becoming mainstream and patients want availability of these modalities. Unlike the U.K., the competitive health care delivery market in the U.S. uses this is a marketing strategy. Hospitals and clinics may offer many services such as:

    Healing Touch (TT)
    Yoga
    Mindful meditation
    Acupuncture
    Massage
    Guided imagery
    Hypnosis
    Biofeedback
    Music therapy
    Herbal remedies
    Diagnostic evaluations
    Nutritional supplements

    While I do not support these practices, this does afford a certain amount of control on the situations where patients who do need the efficacy of standard treatment.

  13. Joe says:

    Zetetic,

    Wishful thinking does not make sCAM “mainstream” in terms of real health care, just as it does not make astrology real. A person who goes to a hospital and is attended by a quack has no assurance that his condition does not need medical attention. One still needs to see a real doctor for a real diagnosis, even in a hospital.

    Medical centers that offer this stuff are simply making a fast buck off the gullible. As Eli Wallach’s character said in The Magnificent Seven “If god did not want them to be sheared, he would not have made them sheep.”

  14. camop says:

    Considering the danger of stroke caused by chiropractors “manipulating” the head and neck, maybe the “no-touch” scam is a safer procedure?

    Next advance in chiro would be a “No-radiation” X-ray. The results would be just as valid and the patient wouldn’t be exposed to dozens of doses of radiation.

  15. dignan says:

    As a logical chiropractor, I approach this topic and comments with caution…simply because I know many of you already have your minds made up about all “alternative” medicines and modalities. However, I would like to share my experience.

    I am a 3rd generation chiropractor, and was raised with a different belief system regarding health. I do know that my belief system is a valid one, based around optimum nervous system function, optimal nutrition, sleep, and exercise.

    I doubt anyone would argue with these essential elements towards a healthy body and lifestyle.

    I have always questioned my parents choices for me, as well as the dogma I was raised around in search of “the truth.” I didn’t care if they were wrong, or I was wrong…I have looked to science and medicine for help, and when the smoke is lifted always end up coming back to the basics I have already named.

    As a practicing chiropractor in the state of Washington, I always find is disturbing when I hear an odd or negative story about a chiropractor…only because I love my profession and wish other chiropractors loved and respected it as much as I do. Unfortunately, I have 100′s of anecdotal miracles that could never be reproduced in a lab…but it doesn’t mean they didn’t happen.

    When it comes to a Non-force technique(like NUCCA, Atlas-Orthogonal, Direct non-force, NET) I also have reservations in their effectiveness, but not greater than the butchering done by modern medicine on peoples spines at outrageous cost.

    The thing not realized in a NUCCA adjustment is there is a tremendous force caused by the weight of a person laying on their side, and the angle of the head piece their neck is laying against that can cause realignment on its own if done properly. The “pulling” a NUCCA practitioner does on the opposite side is to increase this force, but even without it movement can happen. However, this was not this woman’s answer…and that’s her issue for not understanding her own technique.

    The lack of evidence based experimentation is simply due to a lack of funds from the profession itself, and a large corporations(big pharma) supporting an alternative approach that would effect their bottom line.

    If chiropractic adjustments via NUCCA or any other technique were shown to lessen headaches by 50+%(we have a 90% resolution rate in my office) what would that do to the sale of headache medications????

    There may be a lot of CAM providers not doing the best job they can for public at large, but nowhere near the travesties done by medicine and big pharma everyday.

    camop:

    The stroke thing is ridiculous, and has been proven to be an almost non existent risk. There is a greater risk of dying in a car accident on the way to a chiropractors office than being injured. It is simply propaganda of medicine to keep people from seeing one. If there was any risk associated my malpractice insurance would be more than the $1600.00/year I pay.

  16. Joe says:

    Dignan wrote “I am a 3rd generation chiropractor, and was raised with a different belief system regarding health.”

    “Beliefs” are all you can have when you lack “facts;” which is the case here. Chiropractic is a cult (not a profession) resting on the uneducated notions of the Palmers (pere et fils).

    Dignan wrote “The lack of evidence based experimentation is simply due to a lack of funds from the profession itself …”

    So, you acknowledge there is no evidence for chiropractic (there is evidence that they are as effective as masseurs, in certain cases). It does not make sense to proceed “as if” evidence existed. Lack of evidence, by the way, is not due to lack of experiments. You have your own fan mags (e.g., JMPT). The bottom line is that your experiments are atrociously done and unacceptable.

    Dignan wrote “There may be a lot of CAM providers not doing the best job they can for public at large, but nowhere near the travesties done by medicine and big pharma everyday.”

    The, inapt, tuo quoque argument- ducking the facts. That reminds me of the old canard: if it ducks like a quack …

    Dignan wrote “The stroke thing is ridiculous, and has been proven to be an almost non existent risk.”

    Actually, some chiro organizations have found it necessary to recognize the risk. On the other hand, they cannot show any benefit compared to safer procedures. Try to follow this: finite risk divided by zero benefit leads to an unacceptably large risk/benefit analysis (division by zero, get it).

  17. speedwagen says:

    I just started treatment with a NUCCA chiro and I’d like to get some objective feedback from others who have or anyone in the know. Having a scientific background, the theory sounds plausible, but being a cynic to boot, the technique and presentation leave me unconvinced. I don’t want to hear from preachers preaching for their own parish nor naysayers.

  18. Harriet Hall says:

    speedwagen,

    What do you mean by “objective feedback”? You won’t get that from “others who have” used NUCCA. All they can give you is subjective personal testimonials.

    You say “having a scientific background, the theory sounds plausible.” I can tell you that from my scientific, medical, and anatomical background, the theory doesn’t sound the least bit plausible. In fact, it is so implausible that even the majority of chiropractors do not endorse it. NUCCA is only a small sub-sect of chiropractic.

    NUCCA, Atlas orthogonal, and other upper cervical techniques are all outgrowths of the “hole in one” idea originated by BJ Palmer, the son of DD Palmer, who also invented discredited methods like the “nerve tracing” technique where he supposedly could palpate nonexistent nerves. The idea was that realigning the first cervical vertebra would somehow magically make all the rest of the vertebrae fall back into place.

    NUCCA is based on the delusion that the first cervical vertebra is misaligned. They see and measure things on x-ray that conventional radiologists and objective observers can not see. At http://www.skepdic.com/refuge/hoeller.html you can see a typical example of “before and after” x-rays where the NUCCA practitioner creates the illusion of improvement by simply drawing the lines in a different place.

    I don’t doubt that they have many testimonials from satisfied patients, but so do all the quacks and snake oil peddlers. As for actual evidence of the kind that would convince the scientific community, there is none.

    Here’s a link to a forum where chiropractors are discussing it, where one member says “there is NO evidence or indication that nucca does anything at all.” http://chirotalk.proboards3.com/index.cgi?board=c1&action=display&thread=3604.
    And Bob Carroll of the Skeptic’s Dictionary comments on it at: http://skepdic.com/news/newsletter57.html.
    Orac has discussed it at http://oracknows.blogspot.com/2006/01/dubious-therapy-of-week-touchless.html

    I don’t think there is much harm from NUCCA except (1) to your bank account and (2) from the radiation from unnecessary x-rays. And there is certainly a strong placebo effect. So if all you’re looking for is a belief-based treatment that others say has helped them, go for it. But if you want a plausible treatment based on scientific evidence, you went to the wrong place.

  19. Joe says:

    Erm, if I may add, (3) NUCCAS cause strokes through unnecessary manipulations. They argue that all procedures have risks; but a procedure that has no benefit is only a risk.

  20. speedwagen says:

    Harriet,

    I’d like you to tell me about yourself.

    From the little that I’ve read above, you say that you have a scientific, medical, and anatomical background. Can you be more specific? Are you an MD? Do you have a specialty?

    You seem to be on a vendetta against chiro. I’d just like to know where you’re coming from.

    You say that I won’t get objective feedback from anyone with personal experience. I have personal experience and I consider myself objective i.e. unbiased. I wouldn’t want to promote or discount chiro because I don’t know enough. In fact, I’ve yet to experience anything worth promoting; my instinct says quackery, however, as any scientist worth his salt, I’m trying to keep an open mind and not draw any conclusions until I’ve acquired all the evidence. I’ll even say that after I’ve drawn my conclusions, I’ll remain objective; I’ll just say it like it is, take it or leave it.

    Evidently, you don’t believe in chiro and I’m sure you know more about it than I do. I, on the other hand, have always been sceptical, not to say leary, but when you have a medical problem and can’t find a competant main stream physio, ortho or GP after a year, you start to explore the periphery out of desperation. Maybe those like me are precisely who chiros cater to, I wouldn’t know.

    As far as plausibility in concerned, man has yet to fully understand the nervous system. The concept of neural interference/impingement causing pain, spastic contracture, spinal imbalance etc. makes perfect sense. The proposed cause, atlas subluxation, on the other hand, is in doubt. Furthermore, I don’t know how a scant rocking on my neck with a grinding wrist is the solution.

    All I know is I have an old whiplash injury that is predisposed to WAD from just the right amount of jarring on my spine at the right angle and I’ve yet to find anyone who can treat me competantly after a year.

    Joe,

    You also seem to be on a vendetta of sorts. I don’t know if you’re just playing devil’s advocate or you have something more profound to share. What’s your take?

    If anyone has a better idea for me, I’d like to hear it.

  21. Joe says:

    Speedy, go to http://www.quackwatch.org/ or, specifically, http://www.chirobase.org/ and look around. Chiropractors are masseurs with delusions of grandeur. They spend time and money studying nonsense (chiropractic subluxations, Innate Intelligence). There is no reason for you to support that, financially. Find a massager you like.

    Vendetta? Call it a character flaw; but I don’t like seeing people disadvantaged by quacks, let alone killed by a neck-snap.

  22. Harriet Hall says:

    Speedwagen,

    There is a section on this blog titled “About the Authors” that will tell you what you want to know about me. I’ve also written 2 other articles on chiropractic on this blog – have you read them? They will tell you what I think about chiropractic in general. See http://www.sciencebasedmedicine.org/?p=59 and http://www.sciencebasedmedicine.org/?p=94

    You believe you are objective, but I don’t think any human being can be perfectly objective. Personal experience can mislead us, and that is why we have to depend on science to determine the truth. Science does not support NUCCA nor does it support the subluxation concept; it does support the benefit of spinal manipulation treatments for some specific musculoskeletal indications. Science does not support the beliefs chiropractic was originally based on, but it does support some of the things chiropractors do, things that are also done by osteopaths, physiatrists and physical therapists.

    I’m not on any kind of vendetta. I have the highest respect for chiropractors like Samuel Homola (the author of “Inside Chiropractic”) who limit their practice to evidence-based treatments.

    I am trying to promote science and reason over pseudoscience and irrationality. It’s not a question of whether I “believe” in chiropractic or penicillin or any treatment, but whether there is scientific evidence to support it. This blog is all about science-based medicine as opposed to belief-based medicine.

    I’ll repeat what I said before: “if all you’re looking for is a belief-based treatment that others say has helped them, go for it.” If you feel better after the treatments, that may be all that matters to you. But I thought you were asking about the evidence for NUCCA.

    Do you understand that most chiropractors themselves think NUCCA is nonsense? If my criticizing it constitutes a “vendetta” then most chiropactors also have a “vendetta” against their colleagues who practice NUCCA.

    In addition to Joe’s references, here are two more:
    http://your-doctor.com/patient_info/alternative_remedies/various_therapy/chiropractic.html#7

    and http://www.ebm-first.com/?cat=5

    I strongly urge you to read the information on these sites before you make up your mind about continuing with NUCCA.

    You say “If anyone has a better idea for me, I’d like to hear it.” I think the best idea is always to seek out a doctor you can communicate with and trust and who practices science-based medicine, and when you don’t get relief from your treatment, to keep going back to the same doctor and tell him how you feel, and work with him to find a better solution. Sometimes a board certified family physician is the best bet: he can be helpful as a “traffic director” for all your medical care and can involve specialists or a pain clinic if needed.

  23. speedwagen says:

    Harriet,

    I’ve looked through the various webpages you sited and the more I read, the more the scale is tipping towards my initial skepticism. Unfortunately, I’m no further ahead with my problem.

    I’m as proactive as they come and after 16 mo, I’ve hit one dead-end after another. I’ve been to 4 physios, 1 GP and 1 ortho (the only local one who’s willing to touch the spine with a 10′ pole). He started with a facet-joint injection (even though I tried to explain that I didn’t feel my problem was articular, rather neuromuscular) which made my neck worse.

    What you’ve suggested sounds perfect in theory and thats precisely the path I’ve been on, unfortunately, I’ve yet to find someone competant who has a handle on this problem. All they seem to know how to do is raise their hands and say hit-and-miss or refer me somewhere else. By the way, the NUCCA chiro was referred to me by 2 physios. How about that!

  24. AmyH says:

    I discovered this site through a web-search engine. I am not a professional.

    NUCCA chiropractic care has changed my 30 year old son’s life. I am gathering pictures of him since he was an infant showing his twisted head and his progressively worsening posture – until recently receiving chiropractic NUCCA care. I will present these pictures to his chiropractor although the x-rays are proof enough.

    He now has the natural curve to his neck, and his right shoulder is no longer tilted. And he no longer stumbles because of the curved spine.

    And, his communication is better, his eyes are much less extropic and for the first time I’ve noticed a dimple in his smile.
    His brain stem is healing.

    It was a chiropractor who determined the cause of his body imbalance after years of my going to other doctors. I recommend NUCCA care to everyone I know, especially those who notice the big difference in my son. Thank you for reading.

  25. Harriet Hall says:

    AmyH,

    I’m glad your son is improving, but how can you be sure you’re not falling for the post hoc ergo propter hoc fallacy? If you keep reading this blog, you will come to understand how conclusons like yours (“his brain stem is healing”) can be wrong, how easily we can be deceived and can deceive ourselves, why the scientific method is so important, and what constitutes credible evidence.

    If NUCCA could really do what you say, it would be simple for them to document it in the peer-reviewed medical literature and convince the world.

    Just out of curiosity, did your NUCCA practitioner touch your son? This one didn’t. Do you think the brainstem can be healed by someone doing things to their own hands a fraction of an inch away from the patient’s skin?

  26. AmyH says:

    Ms. Hall,

    Yes, there was a hands-on with no pain, no twisting, etc. I was present when the chiro performed the adjustment. He encouraged me to be present being his Mom. The chiro also held a class for new NUCCA patients to explain the procedure and answer questions – this class was held in the evening for any new patient wanting to attend.

    When my son walked out of the clinic after the NUCCA adjustment my sons shoulders were straight. The limp from the curvature was gone. After 30 years of limping the muscles in his back and leg need strengthening, which he is working on.

    He returns weekly for now, but only to receive therapy on a Vivatek which is amazing therapy, and a short test on Myovision which checks tension in the neck. Also a check to be sure the pelvis is still straight. Because the muscles and tendons held the atlas in improper position for over 30 years, the strength of tendons may try to pull the atlas back into its old position.

    It’s all amazing to me and I’m extremely pleased with care. Thank you.

  27. Harriet Hall says:

    I know I can never hope to change AmyH’s mind, but for other readers I’d like to point out once more that there is no credible evidence to support the use of NUCCA and that even most chiropractors reject the method.

    Also, Myovision is a version of surface electromyography, which is a dubious diagnostic technique written up (by a chiropractor) at http://www.chirobase.org/06DD/semg.html

    And Vivatek appears to be a new version of computerized traction (an ineffective treatment which I discussed at http://www.sciencebasedmedicine.org/?p=196) combined with other modalities, not supported by any research studies, and claiming to do things like “normalizing biorhythms, treating the patient’s psyche, and removing neurotoxins” – things that are not believable except for those who desperately want to believe.

  28. Fifi says:

    Zetetic – “These organizations have realized that CAM is becoming mainstream and patients want availability of these modalities. Unlike the U.K., the competitive health care delivery market in the U.S. uses this is a marketing strategy.”

    Actually what those organizations in the UK are doing is mainstreaming CAM (and much of that happening was instigated politically not by the general public, Blair and his wife were/are heavily into woo). Even if the public had demanded CAM services, patients WANT all kinds of things, whether it’s appropriate for a health institution to give them or not should be based in patient need not what they feel like they’d like (since what they like may actually contradict what they need). Surely there are things like more beds, better food, more extensive therapy and so on that would much better serve the patient’s needs (and comfort) than a dollop of woo (woo, after all, is cheaper to provide than more beds, better food and more therapy by a trained medical professional or specialist).

    I’d also like to add that there are things like music and art therapy (or even massage or visualization) are quite different to acupuncture and reiki – they’re not based in an alternative biology that conflicts with what we know about biology at this point in time and are more akin to support groups in that they generally deal with how someone feels, they’re psychological and emotional state (when there isn’t a specific therapeutic goal other than providing solace, a hug and a sense of feeling “better”). None of which is to say that helping people feel better – and offering emotional and psychological support – aren’t something that should be considered alongside with actually making someone well. It’s just more useful when people trained in psychology or an appropriate therapeutic discipline do it than when people who believe bad thoughts cause disease do it – for obvious reasons, or at least I’d hope the reasons are obvious!

    When I refer to music therapy I’m referring to using music in a therapeutic context, not any woo claims related to chanting specific mantras for healing. The difficulty for therapeutic modalities that have been developed within or alongside the mainstream and mainstream institutions – which is the case for art and music therapy as I understand it, which are generally used in mental health contexts – is that when there’s’ a woo version it creates confusion, legitimizes the woo and delegitimizes the medical/psychotherapeutic application, and so on. An example that has been discussed here before is how difficult it has become for scientists who research plants for pharmaceutical use, and how it’s even difficult to get funding for this kind of research now due CAM’s claim that something that was previously mainstream is now “alternative” because they claim it to be – so they’re in charge of funding the studies and choose the ones that support non-science based theories. The same is true of nutrition and exercise.

  29. AmyH says:

    Ms. Hall,

    re: your previous post.

    The words ‘dubious’ and ‘credible’ are not what I consider when the results are keenly obvious to me and others.

    However, thank you all again for allowing me to voice the story on my son’s challenges. I did not mention that he has mild cerebral palsey also, which is most likely why his spinal condition was overlooked for all these years.

    Over the last 30 years my search to help him has lead me to many different corners and am very grateful for the internet web searches. I might add that I am very pleased that the federal government is conducting the complementary medicine trials. Best of luck to you.

  30. Harriet Hall says:

    The words “dubious” and “credible” were not what people considered in the Middle Ages when the results of bloodletting were keenly obvious to both the bloodletters and their patients. Unfortunately, what was “obvious” to them turned out to be wrong. They were fooled, and we can all be fooled just as easily as they were if we depend on personal observations and anecdotal evidence instead of testing our beliefs objectively.

    That’s what science and this blog are all about. I hope AmyH will continue reading this blog and try to understand our thinking, even if she doesn’t change her mind about NUCCA, Myovision or Vivatek.

  31. drdeade says:

    Ok, this is perhaps the most jaded and ill researched website regarding alternative medicine. If you really had researched this article on chiropractic and stroke you would realize that all the data regarding strokes, ie Rand study and even other follow up studies has the likelihood of stroke in a chiropractic adjustment at 1:1.3 million to 1: 500,000. I like the Rand study because the reviewed ALL the data and observed that the rate of stroke can occur in a general population of about 1:400,000. The rate of stoke in a “chiropractic” adjustment is over 3 x lower. This indicates that the likelhood for death or damage by stoke is 3 x lower than a person standing in a crowded room.
    Next, your attack at chiropractic never addresses the research behind it and some of the amazing information found. For example, the prelimiinary study of the Upper Cervical chiropractic adjustment that has been shown to lower blood pressure on average by some 17 points and that is 8 weeks post study. Instead you focus on the 1 in 400,000. Well how about these numbers. Every day the amount of people killed form medical errors, drugs, surgery is equal to 3 747s filled with people. EVERY DAY!!! Out of the millions of adjustment performed daily there are no numbers like that. Perhaps the biggest tell tale sign is our malpractice rates. As we all can agree that insurance companies will dictate with rates based on risk. My insurance is extremely low and I have over a million dollar policy.
    Is there a risk, yes. Is it relatively small? Yes. Do you need to screen your patients? Yes! Do people make mistakes? Yes. It is sad and unfortunate but do not talk about attacking my profession and how many lives that we have changed with your biased, unscientific research page.

    I would like to see critique of our research. An honest to goodness critique. This is where an editor reviews an article that is published in let’s say “Jounral of Manipulative Physical Therapy, (JMPT); SPINE, or the “Journal of Vertebral Subluxation.” You need to realize that we as chiropractors must also apply strigent rules to publicaton of articles and that we too must use t-tables, averages, and be able to understand the difference between a cohort and a cross sectional review. For more information please look at some of these websites that offer scientific reviewed literature, http://www.idealspine.com, http://www.neuromechanical.com

    Personally I could have gone to medical school but it was not about helping the human condition as I found out in college it became about perpetuating the same old “declare war on a disease and then bomb it to death with drugs.”

    The biggest farce to the American public is the perpetuation of cholesterol medication and heart disease. Please look at this. Why is it that the CDC combines several studies that have high cholesterol and diabetes to determine risk factors for cholesterol!!?? Diabetes and cholesterol are two seperate issues and the administration of cholesterol meds should not be recommended if it cannot be shown to reduce the rate of mortality or morbidity in >5 year outcome. That is bad science.

    By the way the Canadian story that you mentioned in your study. They did a canine study to help to prove the case for the victim. However, they were not able to produce a “stoke” with excessive forces to canine’s with significant rotational forces. I will try and locate the study but it was performed from 2001-07 and the outcomes were not what they wanted.

    I would be more than happy to provide other articles to discuss and perhaps even review basic neurology, ie joint mechano receptors, nociception, and even how adjustments begin to improve not only kinesthetic input to the lower brainstem but why it makes sense. As you can tell I do have a lot to say, it’s just that your website crossed my path during a search and I could not let it go unanswered. By the way Subluxations are not like the easter bunny, they do exist and they can be adjusted.

    Respectfully
    Dr. David Eade

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