Articles by JCS

Letter to Science Friday

                                                                                                                                                                                                                                                 Dec. 13, 2013

Christopher Intagliata

Ira Flatow

Science Friday

4 West 43rd St, Suite 306,

New York, New York 10036

 

RE: This Doc's Miracle Drug? Exercise

First of all, let me say I’m a big fan of your show, Science Friday, as well as a public radio supporter for decades. Let me speak with you today about a few concerns with Dr. Metzl’s recent interview, This Doc's Miracle Drug? Exercise.

As a practicing chiropractor for the past 33 years and as a former All-American track runner at UC Berkeley who still jogs 3 miles every morning, I agree with Dr. Metzl's belief that exercise is an essential healthy habit.

But I must add we chiropractors have been preaching the mantra of an "all-natural, no-pill prescription for better health & longer life" for nearly a century. For me it is not new, but apparently it struck a chord with your researchers who perhaps have never considered chiropractic in the same light.

Your program also mentioned: “Sports medicine doctor Jordan Metzl says he's found a miracle drug that prevents almost every illness, is 100 percent effective, and has very few side effects: exercise.”

I would wager if a chiropractor were to make the same statement, most likely it would be dismissed as hyperbole. But when an MD makes such a bold statement, he/she is heralded as progressive, insightful, and gets booked on your show!

However, one notable flaw by Dr. Metzl was his mention of "herniated discs" causing back pain. I realize this is an historically-accepted belief, however, MRI spine research beginning in 1990 invalidated this viewpoint when "bad discs" were found in pain-free people.[1] This finding has been duplicated many times over the past 23 years to the point researchers now refer to “bad discs” as incidentalomas.[2],[3],[4]

In fact, most back pain (excluding cancer, fractures, or infections) is caused by joint dysfunction, which explains why spinal manipulation works so well to relieve pain by restoring proper joint motion.[5] More attention is now given to how the spine functions than to what it looks like on an MRI or x-ray.

Although Dr. Metzl suggests exercises are beneficial, what he fails to provide your listeners is the need to restore the normal joint play via manipulative therapy before flexibility exercises will be maximally effective.

Certainly many of the musculoskeletal disorders Dr. Metzl speaks about—back, knee, hip, foot pain—can be helped naturally with manipulative therapy. However, researchers admit most MDs are not schooled in musculoskeletal disorders and only a very few osteopaths or physiatrists now practice manipulative therapies.[6]

Indeed, chiropractors alone have championed this treatment while taking medical cheap shots across our bow for over a century to preserve this healing art. This reinforces the notion that ‘yesterday’s unorthodox treatment is tomorrow’s standard of care.’

As a regular listener to your show, it dawned on me that I’ve never heard any mention of the chiropractic approach to health or back pain, so I checked at  http://www.highbeam.com/publications to discover how often chiropractic has been discussed on Science Friday. To my astonishment, the results showed 0 of 2,791 articles.

In light of the current healthcare crisis where all options are on the table to reduce costs and improve outcomes, perhaps a fresh look by Science Friday at unorthodox care is warranted as the editors of The New York Times Sunday Review noted:

“No matter what happens to President Obama’s health care reforms after the November elections, the disjointed, costly American health care system must find ways to slow the rate of spending while delivering quality care. There is widespread pessimism that anything much can be achieved quickly, but innovative solutions are emerging in unexpected places.”[7]

Indeed, the omission of chiropractic care as an “innovative solution” in an “unexpected place” could well be an immeasurable help to your listeners. Below are just a few obscure examples of the ascent of chiropractic care in spine care after a century of medical defamation:

  • In 1994 an agency of the USPHS recommended spinal manipulation as a “proven treatment.”[8]
  • Back pain is the #1 disabling condition in the nation with total costs nearly $3 billion annually.[9]
  • Chiropractors are now considered America’s primary spine care providers as the third-largest physician-level healthcare profession in the world.[10]
  • Medical spine care has become a “national scandal” and deemed the “poster child for inefficient spine care” as the editor of a leading international spine research journal recently admitted.[11],[12]

Wouldn’t this be helpful information for your listeners considering 90% of Americans in their lifetime will suffer from a bout of disabling back pain and the one-third of adults will suffer with chronic back pain on a daily basis?[13] And this isn’t even discussing the role of neurophysiology in the help of organic disorders, perhaps the most controversial issue of all.[14]

Indeed, whether discussing the role of chiropractic care for musculoskeletal or organic disorders, or discussing the medical war against chiropractic, it is bound to make for an enlightening discussion for your listeners.

I hope to hear back from you on this issue.

Regards,

JC Smith, MA, DC

www.chiropractorsforfairjournalism.com

 



[1] SD Boden, DO Davis, TS Dina, NJ Patronas, SW Wiesel, “Abnormal Magnetic-Resonance Scans of the Lumbar Spine in Asymptomatic Subjects: A Prospective Investigation,” J Bone Joint Surg Am. 72 (1990):403–408.

[2] Deyo RA. Conservative therapy for low back pain: distinguishing useful from useless therapy. Journal of the American Medical Association, 1983;250:1057-62.

[3] Kim JS et al., Prevalence of disc degeneration in asymptomatic Korean subjects. Part 1: Lumbar spine. Journal of the Korean Neurosurgery Society, 2013; 53(20:31-8.

[4] Lee TH et al., Prevalence of disc degeneration in asymptomatic Korean subjects. Part 2: Cervical spine, Journal of the Korean Neurosurgical Society, 2013; 53(2):31-8.

[5] Transcript of testimony of John McMillan Mennell, M.D., Wilk v AMA transcript pp. 2090-2093.

[6] KB Freedman, J Bernstein, “The Adequacy Of Medical School Education In Musculoskeletal Medicine,” J Bone Joint Surg Am. 80/10 (1998):1421-7

[7] Editorial, New York Times Sunday Review, “A Formula for Cutting Health Costs,” July 21, 2012

[8] S. Bigos, et al., “Acute Low Back Problems in Adults, Clinical Practice Guideline No. 14,” U.S. Public Health Service, U.S. Dept. of Health and Human Services, AHCPR Pub. No. 95-0642, Rockville, MD: Dec. 1994.

[9] The Burden of Musculoskeletal Diseases in the United States Bone and Joint Decade, Copyright © 2008 by the American Academy of Orthopaedic Surgeons. ISBN 978-0-89203-533-5, pp. 21.

[10] Donald R Murphy, Brian D Justice, Ian C Paskowski, Stephen M Perle, Michael J Schneider, The Establishment of a Primary Spine Care Practitioner and its Benefits to Health Care Reform in the United States, Chiropractic & Manual Therapies 2011, 19:17

[11] The BACKPage editorial, vol. 27, No. 11, November 2012.

[12] US Spine Care System in a State of Continuing Decline?, The BACKLetter, vol. 28, #10, 2012, pp.1

[13] Scott Haldeman DC, MD, PhD, FRCP(C) and Simon Dagenais DC, PhD. A supermarket approach to the evidence-informed management of chronic low back pain. The Spine Journal, vol. 8, Issue 1, January-February 2008, Pages 1-7.

[14] DR Seaman, JF Winterstein. “Dysafferentiation, a Novel Term To Describe The Neuropathophysiological Effects of Joint Complex Dysfunction: A Look at Likely Mechanisms of Symptom Generation,” J. Manipulative Physiol Ther 21 (1998):267-80.

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