Articles by JCS

Tide is Turning

The Tide is Turning

 What a week we’re having!

 First the Forbes magazine contributor/yellow journalist, Steven Salzberg, wrote a defamatory article, New Medicare Data Reveal Startling $496 Million Wasted On Chiropractors, in which he concludes,

If we want to start controlling the cost of Medicare, here’s an easy first step: stop covering chiropractic. We will save $496 million a year, and people’s health will improve.”

 The push back was phenomenal unlike I’ve ever seen with over 268 blog responses within the week and more likely to come as word spreads.

 Also this week were two other startling critiques of medical spine care methods—epidural steroid injections and spine fusions.

FDA Announcement

 First on April 23, the FDA issue this Drug Safety Communication:

Posted 04/23/2014 by the U.S. Food and Drug Administration

Epidural Corticosteroid Injection: Drug Safety Communication - Risk of Rare But Serious Neurologic Problems

Including methylprednisolone, hydrocortisone, triamcinolone, betamethasone, and dexamethasone

AUDIENCE: Pain Management, Anesthesiology

ISSUE: FDA is warning that injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. The injections are given to treat neck and back pain, and radiating pain in the arms and legs. The effectiveness and safety of epidural administration of corticosteroids have not been established, and FDA has not approved corticosteroids for this use. 

RECOMMENDATION: Patients should discuss the benefits and risks of epidural corticosteroid injections with their health care professionals, along with the benefits and risks associated with other possible treatments.

Finally the truth about these expensive, dangerous, and worthless steroid injections are coming from the FDA. However, it fails to mention the likelihood of osteoporosis in the spine from these steroid injections. And what is the likelihood of MDs and pain management specialists telling patients to seek chiropractic care first as a mandate of their ‘informed consent’? Okay, stop laughing because we know that’s never going to happen.

Modern Healthcare Magazine 
This healthcare magazine highlighted stats from the Medicare report that was released recently after 35 years of being repressed by the AMA. Needless to say, the figures were shocking, even for a medical business magazine.

Medicare data cast spotlight on most prolific spinal surgeons

By Joe Carlson @ Modern Healthcare April 24, 2014

Experts have long been alarmed by the growth rate of spinal-fusion surgeries. Now, an analysis of new Medicare data by CBS News shows that a disproportionate number of the most risky and highest-paying procedures are being performed by a small group of high-volume spinal surgeons.

Under Medicare payment rules, the riskiest surgeries are also paid the most because they involve fusing more vertebrae together. The analysis found that just 5% of all spinal surgeons performed 40% of Medicare surgical cases that fused four or more spinal bones.

There were more than 465,000 spinal-fusion operations in the U.S. in 2011, compared with 252,400 in 2001, according to the Agency for Healthcare Research and Quality...The estimated cost of spinal-fusion procedures was more than $12.8 billion in 2011, according to AHRQ. Hospital costs alone for a spine procedure average $27,568 and total costs can hit six figures for major spinal-fusion procedures, experts say.

There are many potential explanations as to why some doctors recommend the highest-paying, yet riskiest surgeries far more often than do their peers. It could be that high-volume spine surgeons benefit from referrals, or simply that their clinical judgment is different.

But the CBS report noted that spinal-fusion surgery pays about five times more than less-risky alternatives, raising the question of whether some doctors are letting financial considerations influence their recommendations. A University of Wisconsin expert interviewed by the network said the data may show some doctors are “operating outside of the generally agreed upon … parameters” for spinal surgery.

CBS News

Another shocking critique of spine fusions appeared on CBS News on April 24, 2014, “Tapping into controversial back surgeries.”

 You’ve got to watch this seven minute expose; unfortunately the only mention of chiropractic care was that it failed the primary interviewee, which demanded a response from me in the Comment section. I’ve posted it here for your review and please post one yourself.

 JC Smith, MA, DC

THE DISC THEORY IS DEAD; DON'T BE MISLED

In 1990 Dr. Scott Boden at Emory did seminal MRI research showing 'bad discs' were common in pain-free people, debunking the main reason for spine fusion. His research has been duplicated every year since then albeit ignored by greedy spine surgeons and now 'bad discs' are deemed 'incidentalomas' because they are not the primary problem to most back pain, which is joint dysfunction.

People are unaware that there are over 137 synovial joints in the spinal column and 313 total joints—including the syndesmosis and symphysis joints--when ribs, pelvis, skull are included. This is the paradigm shift people need to understand: you don’t slip discs as much as you slip joints, to use lay vernacular.

Although 10% of back pain is attributed to pathologies like cancer, fracture, infections and the rare 1 in 100 truly ruptured disc cases, the vast majority of back pain is  now deemed 'mechanical' in nature, which means the spinal mechanics are deranged principality due to joint misalignment and compression. This 'path-physiological' (bad function) perspective has replaced the 'patho-anatomical' (bad discs) reasons used by surgeons.

Look at ‘bad discs’ rationally and ask, ‘why would discs herniate or later degenerate?’ This doesn’t occur until the spinal mechanics are deranged like a football knee issue. This explains why any treatment that realigns joints, increases motion, and strengthens the joint dysfunction works best, such as chiropractic care, therapeutic massage, spine decompression/ exercises, yoga, Pilates, etc.

On the other hand, the medical spine care methods of opioid painkillers, epidural shots, and spine fusions generally fail or are short term at best is because they do nothing to restore joint play, the essential component of a healthy spine.

Although Ms. Smith in this CBS video had tried a chiropractor, I would urge her and people in her situation to find another since there are 65 major chiropractic methods. For acute or chronic low back pain, I would suggest non-surgical spinal decompression known as the Cox distraction method or spinal decompression methods like the DRX or Kennedy methods.There are many good methods, so ask around in your town for a good chiropractor who specializes in low back cases.

Once the proper adjustments are made, I cannot emphasize enough that daily spinal exercises are essential. Spine care is a daily issue just like dental care, and the sooner you understand the need to maintain joint motion and spinal strengthen and flexibility, the sooner you’ll feel good again.

You can learn more at www.chiropractorsforfairjournalism.com

The Tide is Turning

Hopefully this tide of negative exposure for medical spine care methods will continue. It would have been even more impactul if another news article had revisited the Hillbilly Heroin epidemic that killed more Americans in 2012 than car accidents at over 37,000 victims. This topic was covered by Dr. Sanjay Gupta’s Deadly Dose, but he apparently suffered from ‘professional amnesia’ and failed to mention chiropractic as a non-drug solution to the epidemic of back pain, the cause of pain for 65% of these victims.

 Instead, millions of patients were led down the medical path to opioid addiction that is only getting worse with stronger forms of synthetic heroine. Certainly the Hillbilly Heroin epidemic remains rampant as the so-called “pill mills” dispense opioid painkillers like Halloween candy, creating an unchecked epidemic of narcotic addiction to the point that Thomas Frieden, MD, director for the CDC, minced no words when he said, “physicians have supplanted street corner drug pushers as the most important suppliers of illicit narcotics.”[1]

 With this growing evidence against medical spine care, dubbed “The poster child for inefficient spine care” by Mark Schoene, editor of THE BACKLETTER, a leading international spine research journal. Actually, he was being nice when he said “inefficient.” I would say more often than not it is a case of “deceptive, disabling, and dangerous” spine care.

 We can now show chiropractic beats surgery in a recent study in Washington State that compared workers with low back injuries.[2]  Isn't it time the entire nation and news corps learned of this study as well as the many other studies and guidelines that recommend our brand of care?

 It’s time for our two national association in conjunction with the F4CP and every state association to promote our brand of spine care as safe, effective, and  ‘proven treatment’ as deemed by the AHCPR back in 1994. The only thing that has changed over the past 20 years is that the evidence has grown stronger in our defense.

 Indeed, it’s time for DCs to claim the role as America’s primary spine care providers.

 


[1] Centers for Disease Control and Prevention Press Release, CDC Vital Signs: Overdose of Prescription Opioid Pain Relievers—United States, 1999-2008; 2011: www.cdc.gov/media/releases/2011/t1101_presecription_pain_relievers.html .

[2] Keeney BJ, Fulton-Kehoe D, Turner JA, Wickizer TM, Chan KC, Franklin GM., Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State.,Spine (Phila Pa 1976). 2012 Dec 12.

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