spinecor

[MATJESNIC]

I think electric stim is great for loosening up muscles. It's like a bunch of little fingers doing rapid massage. I never believed it to have any purpose other than that.

[structural75]

If this explanation helps anyone at all, here it is...

Electric stimulation delivers an intermittent impulse to cause the muscle fibers to contract, followed by a relaxation response. It is meant to interupt nerve impulses creating the chronic contraction in spamadic, cramping or just plain "tight" muscles. Its effects are short term at best usually... purely palliative effect if that. As Linda R said, not worth the time unless it's "free of charge".

Hi Bizzleber,

I don't know a lot about chiro and/or adjustments. What are the issues? Is it dangerous, or might it make the scoliosis worse? It was suggested to me for my son, but I know a lot of the literature suggests that it is a waste of time.

It seems that chiropractic draws a lot of confusing and mixed responses so maybe this might help in answering your question. (By the way, I'm not a chiro, nor do I have any bias or aversions towards it... all things have their appropriate and limited uses.) I do however have a working, educated and professional understanding of the musculoskeletal body, so an explanation of what chiropractic adjustments are actually doing might help lend some clarity to its intended use and misuse alike.

Vertabral joints (we'll limit it to that for now) have varying ranges of motion in respective portions of the spine. When a joint is put through a range that the nervous system deems unacceptable or dangerously compromising it will send messages, or impulses, to the muscles surrounding the joint to immoblize it... essentially 'fixing' it in place. The end result, you can't turn your head one direction, or bend over, etc. Sometimes it's a nagging constant pain, sometimes radiating to other regions if it is a true nerve impingement. (Studies have shown only about 20 - 30% of pain comes from actual nerve entrapment, i.e. - pinched nerve). Either way, it will inhibit those vertabrae involved from moving properly, if at all.

The common phrase, and misnomer, is that our back is "out" (a.k.a. - subluxation). It's not that it's "out", but rather the articular facets (joints) are 'fixated' either; open, closed, translated or a combination thereof, all to varying degrees. In fact, a vertabrae can be in perfect "alignment" to it's neighbors but be fixated, which will carry the same consequences.

Adjustments will usually, but not always, 'free' the fixation by quickly stretching the ligaments and joint capsules surrounding the joint. Sometimes it lasts, sometimes it doesn't. What it does not do is address the actual cause of the fixation (the tissue positioning the bones), which is why so often the problem will return in the same regions, or the strain will be transferred throughout the spine elsewhere. Thus the need to continue receiving adjustments, and thus the reasoning why one should cease treatment if it doesn't show lasting improvement within about a month of care.

The 'popping' sound is a process called cavitation. As the joint is seperated slightly a negative space is created within the capsule and gas is released to fill the void. Popping sounds do not necessarily mean that an adjustment was successful or properly done, nor is it necessary to hear the pop to achieve a successful adjustment.

Will it help/harm scoliosis? No comment by me on that one. I'll say this, adjustments done on a regular bases are interpretted by the body as a form of whiplash. They should be used sparingly, when necessary. If the scoliosis is accompanied by something such as Chiari, it is an absolute no no!

My personal opinion on adjusting kids... wouldn't let ANY chiro, even the best, adjust my daughter's spine. Inappropriate and unnecessary at those stages of early development. If I had to I would bring my child to see an Osteopath for an adjustment... they have more diverse methods for "adjusting" vertabrae that don't involve cracking, popping or thrusting things back into place. (Vertebral adjustments began with Osteopathy, not chiropractics)

Hope that lends a bit of clarity on the "what", "why" and "how". I find it helps to know those three things before answering "when" and "where".

Take Care,
Structural

[MATJESNIC]

Structural,

Thanks for taking the time to explain. I have been fortunate in that the times I have turned the wrong way or done something to my back, the chiro has been able to help me in only about a handful of visits.

I didn't know that a D.O. could help in this area.

Melissa

[structural75]

Melissa,

D.O.'s in the U.S., as I'm sure you know already, are equal to M.D.'s. All of the D.O.s receive some training in manipulative treatment, but only a small few pursue that approach, develop the skills and bring it into their medical practice (And frankly, only a small percentage of them are talented at what they do, as with any manual/hands-on practice.). Those that do usually limit their medical practice strictly to manipulation... some go on to do another 4000 - 5000 hours of training to become a cranial specialists (Cranial Osteopathy).

It's more prevelant in Europe to find Classical Manipulative Osteopaths (as it was originally intended by its founder, Andrew Still, M.D.) than it is to find a chiropractor. It's the opposite here, but they do exist. They can do everything the chiro does and then some, one big difference being the premise of their work and how they perform it.

My wifes OB/GYN is a D.O. who also occassionaly utilizes gentle manipulations in his practice. It's comforting for us to know the person doing them is also medically knowledgable.

Best,
Structural

[Celia]

Structural,

How does one go about finding a reputable D.O. ?



Melissa,

Good luck tomorrow and give us an update when you can!

[LindaRacine]

Celia...

Not that it means everything, but there are several DOs who are members of the Scoliosis Research Society.

Regards,
Linda

[structural75]

Melissa,

I'll respond more specifically to your question later... putting my daughter to bed now.

Here's a link on Osteopathy... a very, very reputable one at that. (kind of the grandma of Osteopathy if you will)

http://www.osteopathiccenter.org/scoliosis.html

Talk soon,
Structural

[gerbo]

what does DO stand for??

[Celia]

I would think Dr. of Osteopathy

[mrf]

Braced!

Okay - so we did it. My daughter (age 12 risser 0) was fitted by Dr Deutchman in New York with Spinecor. Her out of brace x-ray showed top curve of 28.5 and bottom of 22.6 (a small progression since her initial x-ray in September which was at 25). After Spinecor brace - top 23.3 bottom 18.1. Not a huge correction - nobody was doing cartwheels but the Dr was (mildly) pleased. Again, I was hoping for much more but am glad there was some correction to see. As others have said it's amazing to see any correction from a "simple piece of elastic." I'm still so nervous about the brace - The cynic in me thinks there may have been some exaggeration of the curve one way or the other to show a correction - I know it's a trust issue that I need to deal with. (Part of my problem is that last month the orthopedist who fitted her with the TLSO measured her inTLSO brace at 16 - a number I like much better and was hoping to still see this time with Spinecor - When I call the ortho to update him is he going to give me the "I told you so" speach?)Dr. Deutchman did say that often the numbers go up and down depending on the child's growth etc and not to get too hung up but when the numbers are the only thing we have to base success on, it becomes somewhat irrational - like watching the stock market every day. I also can't get over how flimsy the brace is - as if it's so easy to put it on too high above the hips or strap it on too loose. But my daughter seems to be okay with it and is able to put it on herself. She even wore the brace to her basketball game last night with no problem.

Dr Deutchman's office does vestibular testing - not sure if others do this as well. At first I thought it was inconsequential, but I must say that I did see that one eye reacted differently than the other when tested. The relationship between the back and eyes/ears seems to make some sense. He gave her various physical therapy exercies to do so we are going ahead with that too. All in all an exhausting experience. I continue to struggle to maintain a positive attitude - even though on the inside I'm still unsure. Catch me in 2-3 years - I hope to be a little more decisive then!!

[structural75]

That's correct, Doctor of Osteopathy. The equal to M.D.s in the U.S. (qualified to practice internal medicine and perform surgery.) Just like M.D.s, D.O.s perform residencies and internships alongside their counterparts, and may continue into any area of specialty... neurology, pediatrics, ob/gyn, orthopedics, etc. The primary difference in their training here in the U.S. lays in the whole systems view of the body as it relates to healthy function and disease (i.e. - How does illness/disease of one organ or system affect all the rest?... for example). And again, it also teaches skills for manual diagnosis and treatment (Osteopathic Manipulative Techniques - OMT)

Not the same as Doctor of Chiropractics (They have Doctorate degrees but are not trained as physicians, surgeons or practitioners of internal medicine in any way.) Their title is often misleading.

[gerbo]

this http://www.bmj.com/cgi/content/full/319/7218/1176 link gives an interesting overview re osteopaths and chiropracters. Just for fun, (and further clarification), follow the links at the end towards the letters.

[structural75]

I read the article and the threads at the end. I wouldn't say it clarified anything... but rather confuses the matter more by lumping the two disciplines into the same category. The same has been done in writings about my own profession, comparing it to massage therapy. Having been formally trained in both I can say quite certainly that they are worlds apart.


A response to that article was given by an Osteopathic Physician (U.S. trained/M.D., allopathic equivilant). It read as follows:

It was with interest that I read the review of osteopathy and chiropractic by Andrew Vickers and Catherine Zollman. I am an Osteopathic Physician in the United States and my husband is a Chiropractor. While it is true that there are commonalities in the techniques used in chiropractic and osteopathy around the world there are also significant differences, and that is especially true in the United States.

Since the authors chose to identify that Osteopathy and Chiropractic were both systematiised in the United States they should have acknowledged the current practice of Osteopathy in the States and the reason for the differences in practice and title of D.O.'s (Doctor of Osteopathic Medicine) in the US and in Europe.

Andrew Taylor Still was an MD trained in the practice of medicine. There was a split in early Osteopathy when the use of pharmaceuticals was introduced into the curriculum. And that led to the development of the European branch of Osteopathy which remained solely manipulative and drug free.

There are D.O.'s who practice as neuromusculoskeletal medicine specialist's in this country, and in those cases there are many similarities between how many chiropractors might practice. The diagnosis and treatment of somatic dysfunction is at the core of the practice of Osteopathy around the world. An examination of this concept would have been useful to readers. More helpful also would have been the statements of the philosophy undergirding each profesion and the definition of each by the professions themselves.

Schools of Chiropractic in the US have a heavy emphasis on nutrition in the curriculum. In the United States, Many states do license the chiropractors as Doctors of Chiropractic-it is NOT purely a courtesy title (although there are many MD's who would like it to be)but a professional licensure and designation with legal obligations a privileges.

In all, I feel that this article gives a very superficial, limited and inadequate representation of both the professions of Osteopathy and Chiropractic. From the article content aside from the high velocity technique the titles of phsyical therapist or massage therapist could have been substituted and little would change.

Sincerely, Anette Mnabhi, RN, MSN, D.O. (Doctor of Osteopathic Medicine) (USA)

The co-author of that article in the British Medical Journal then responded as follows:

Numerous responses to the "ABC on osteopathy and chiropractic" have pointed out, in short, that things are a bit different in the USA." I did actually know this but would like to point out that the paper was published in the British Medical Journal, aimed at a British audience and written under a strict word limit. Obviously, it's going to be difficult to give a full description of variations in training, qualifications and approaches in different countries of the world....

I wouldn't rely on this type of analysis/publication to educate myself on the differences/similarities between the two practices. From my extensive experience with both, I can conclude that the article was very poorly researched.

Osteopathy was founded in the mid to late 18th century by an American M.D., Chiropractic was 'conceived' in the 1890's by a Grocer and Magnetic Therapist... Very different origins, if I must say... .

[structural75]

Oh, by the way, this is a good example of how we must always consider the source of our information gathering. No one article, study, etc. is the be all, end all.

And Melissa,

I hope all of that answers your question.

structural

[MATJESNIC]

Thanks for all of that info, Structural.

We are back from Montreal. Nicole's back has stayed the same, which is good news. Since her diagnosis 16 months ago, her bottom curve has stayed near the 40 degree mark.

Her curves in-brace are 28 and 34. Her risser is still a 0. Until it is at least a 3, they can't make an intelligent prediction. She is done growing in the legs but could still have some growth left in the trunk. But it is also possible that she is done growing. I learned that just because your risser is a 0 doesn't mean that you are still growing.



Dr. Rivard doesn't believe in surgery until 50-55. He said that the fact that her back sometimes hurts without the brace doesn't mean anything. He told me to stop worrying so much. I told my husband and Nicole that if her back is stable, we will enjoy the next five months and remain positive. We are still in the game. So I am going to remain positive. I am forever thankful and grateful for Spinecor and the doctors in Montreal. Nicole is leading a comfortable, normal, active life in her brace. The only regret is that we didn't go there from day one. But we are thrilled that we go there now.

Thanks to all of you for support and concern. I really appreciate it.

Melissa