Biased Media Links Strokes to Chiropractic
A recent study associating chiropractic care with an increased chance of stroke has heightened frustrations within the chiropractic community regarding the medical bias promoted by the media.

The study, which appears in the May 13 issue of Neurology, stated that chiropractic neck adjustments may increase chances of suffering a stroke by causing tears in neck arteries. Involving patients under 60, the research took place between 1995 and 2000. Fifty-one patients at the University of California San Francisco (UCSF) and Stanford University who suffered arterial tears and strokes or mini-strokes were compared with 100 control patients who suffered strokes from other causes. They were surveyed on risk factors such as high cholesterol, high blood pressure, diabetes, and whether they received chiropractic treatment in the month before their strokes.

Results showed that those with arterial tears were six times more likely to have undergone recent chiropractic treatment. Although there was no definitive evidence linking stroke victims to chiropractic and the authors of the study stated the overall risk remains quite small, news headlines accused chiropractic of causing strokes.

Numerous studies, involving thousands of patients, contradict the finding of the recent study in Neurology. The World Chiropractic Alliance (WCA) responded with a press release to all major wire services, acknowledging the intensified medical bias against chiropractic proven by the amount of press the study received. According to the American Chiropractic Association, the study is fraught with design flaws, provides little new and useful information, and needlessly alarms the public about a safe and effective form of treatment for neck pain and headaches.

“When you depend on the medical and drug trades for much of your income, it’s easy to fall into the trap of being their lackeys and using their propaganda without asking hard questions,” said Terry A. Rondberg, DC, WCA president. “If the news media ever hopes to regain its credibility, it needs to re-examine its practice of sensationalizing reports that attack chiropractic. The WCA challenges the news media to do some real investigative reporting and tell the truth about the ongoing campaign against chiropractic by the medical and drug industries.” CP

Chiropractic Benefits Aimed for Military Personnel
The US House of Representatives recently passed legislation that includes a provision to accelerate implementation of the new chiropractic benefit in the Department of Defense health care system. The bill was approved, 361 to 68, bringing active-duty military personnel one step closer to getting access to chiropractic services.

The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) lobbied successfully for a specific legislative directive to be included in the House version of the 2004 Department of Defense authorization bill, HR 1588, requiring accelerated implementation of chiropractic health care services for active-duty military personnel and setting the target date of October 1, 2005, for full implementation.

“This is a victory for our troops,” said Daryl Wills, DC, president of ACA. “After taking a close look at the impact on readiness and overall health, the US House of Representatives voted to speed implementation of the chiropractic care services that America’s military personnel need and want. On behalf of the ACA, dedicated doctors of chiropractic who are eager to serve, and thousands of active-duty personnel who are chiropractic patients, I want to thank Representatives Duncan Hunter, John McHugh, Ed Schrock, and Senator Jim Talent (R-Mo) for their leadership and unwavering commitment to the well-being of America’s servicemen and women.” CP

Geriatric Patients Benefit from Electrical Acupuncture
Chronic low back pain in older patients may be relieved through percutaneous nerve stimulation (PENS) via acupuncture needles, according to a study published in the May issue of the Journal of the American Geriatrics Society. Improvements in mood, physical performance, life control, as well as in timed chair rise, lifting endurance, and psychosocial function were also observed.

Researchers randomly assigned 34 patients (at least 65 years of age) with chronic back pain to receive PENS twice a week, plus physical therapy modalities, or sham (needle placement without electrical stimulation) PENS and physical therapy modalities for 6 weeks. Results were assessed following the 6-week period, and again after 3 months. Although results were positive in a testing environment, more testing and validation is needed before PENS becomes regular treatment in clinical practice. CP

Parker College Brings Together Veterinarians and Chiropractors
To provide instruction in the use of chiropractic care for injured animals, Parker College of Chiropractic, Dallas, presented Chiropractic for Animals on May 10–12. Aimed to prepare chiropractors, veterinarians, and students enrolled in professional programs at accredited colleges for the American Veterinary Chiropractic Association examination, the course included more than 200 hours of materials presented and more than 74 hours of hands-on instruction using live animals. The session also included adjustments on small animals at the Parker College campus and a trip to a local ranch to adjust horses. This ongoing postgraduate program occurs 4 days a month for 6 months through October. CP

ACA Appeals Court Decision in Anti-trust Lawsuit
The federal antitrust lawsuit brought against Anthem Blue Cross and Blue Shield, Southeast region (formerly Trigon Blue Cross Blue Shield) by the American Chiropractic Association (ACA), the Virginia Chiropractic Association, and several chiropractors and patients, was dismissed on April 25 by Judge James P. Jones of the US District Court in Abingdon, Va.

According to the ruling, the claims of antitrust conspiracy, state law conspiracy, monopolization, tortious interference with business expectancies, and breach of contract were without merit. There was not sufficient evidence that the members of the advisory panel of Anthem personally benefited financially from its discriminatory policies taken toward chiropractors.

In response to the ruling, the ACA and the other chiropractic plaintiffs are expected to appeal Judge James’ decision. CP

ACL Tears More Commonly Affect Women
Women athletes may need to change their training techniques to better protect their knees. According to a new study in the May 2003 issue of The Journal of Bone and Joint Surgery, women who participate in jumping and pivoting sports, such as basketball, volleyball, and soccer, are up to eight times more likely to rupture the anterior cruciate ligament (ACL) of the knee than are same-size men participating in these same sports.

Researchers compared 24 athletes (12 women and 12 men) who were competing in sports associated with risk of ligament injury to 28 endurance athletes (14 women and 14 men) active in sports with low risk of ligament injury, such as bicycling, crew, and running. Pairs of men and women were matched based on age, height, weight, body mass index, shoe size, and activity level. Devising several tests to measure knee stiffness, researchers found that voluntary increase in knee stiffness after contracting knee muscles during pivoting, jumping, and turning sports was greater in men than in women participating in the same sports, thus decreasing their chances of harming their ACL. Women competing in nonpivoting sports exhibited a higher increase in knee stiffness on muscle contraction than either men in non-pivoting sports or women in pivoting sports.

Although the scope of this study did not explore the reasons for the gender differences other than to theorize that men and women may activate the knee muscles differently during athletic activities, the researchers concluded that improving active muscle protection of the knee during training may help decrease rates of knee injury among women athletes. CP

Study Confirms Results of Massage Therapy
After an in-depth review of evidence from dozens of studies of alternative treatments, researchers from Group Health Cooperative’s Center for Health Studies (CHS) found that massage is an effective treatment for relieving symptoms and increasing function among people with persistent back pain. Results of the review were reported in the June 3 issue of the Annals of Internal Medicine.

According to the article, spinal manipulation has clinical benefits for back pain—about the same as conventional medical treatments such as over-the-counter pain relievers and various types of physical therapy.

“Many Americans are using alternative treatments for back pain and paying a fair amount of money for them—either out-of-pocket or through insurance companies,” says Daniel C. Cherkin, PhD, senior investigator at CHS and the lead author of the article. “So, it’s important to know whether these treatments are effective and whether they should be made more widely available.”

Studies show that back pain accounts for 40% of visits to chiropractors and 20% of visits to massage therapists; although evidence in scientific data of the effectiveness of acupuncture for back pain remains unclear, back pain accounts for 14% of visits to acupuncturists. CP

Pharmaceutical Companies Fall Under Scrutiny
According to recent articles published in the British Medical Journal, the growing concern in the medical community to create a separation between physicians and pharmaceutical companies is escalating. Unnecessary prescribing, influencing the priorities of patients’ organizations, and biased treatment studies are some of the primary issues facing the medical community regarding drug companies.

As part of their promotional efforts, drug companies sponsor approximately 300,000 events for doctors every year in the United States. In an effort to change the existing relationship with the drug companies, the University of California, San Francisco (UCSF) is considering plans to end free lunches hosted by drug companies and to remove drug representatives.

“In some ways, we are all addicts to big pharma’s money,” says Mark Laret, CEO of UCSF Medical Center. “However, we are going to have to wean ourselves off a dependency that is generally inappropriate. This relationship is one of those things we need to clean up. The sooner the better.”

Individual physicians and their professional associations face difficult choices between remaining part of the pharmaceutical industry’s extended promotional vehicles, or seeking real distance from the drug companies to provide prescriptions, education, and advice that is truly independent.

A study that questioned more than 1,000 general practitioners randomly selected from 200 practices in England found that frequent contact with a drug industry representative was significantly associated with a greater willingness to prescribe new drugs. Also, these practitioners more likely agreed to patients’ requests to prescribe a drug that is not clinically indicated. General practitioners who saw drug representatives most often tended to be single-handed practitioners and working in deprived areas. Seeing a representative at least once a week lead to unnecessary prescribing.

Drug companies also have a strong influence on patient organizations in the United Kingdom. Whereas advertising drugs to patients is not allowed, pharmaceutical companies provide grants and conduct joint projects with patient organizations. Since most patient organizations are poor and have little independent funding, this helps the organizations grow, however it can also distort and misrepresent their agendas.

With their own goals to promote certain drugs, pharmaceutical companies tend to publish studies with more favorable results, suggest researchers who identified 42 studies submitted to the Swedish drug regulatory to secure marketing approval for five antidepressant drugs that were different from the actual published studies between 1983 and 1999. The tendency to report the more favorable results only, in studies actually published, was a major cause for bias. Researchers suggest reading unpublished studies, as well as published studies, for more comprehensive knowledge about drugs. CP