Talk:Spinal manipulation

From Wikipedia, the free encyclopedia

	This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
B	This page has been rated as B-Class on the quality assessment scale
Mid	This article has been rated as Mid-importance on the importance assessment scale

[edit] Redirect for lack of a proper article

The redirect takes one to the chiropractic concept of Spinal adjustment, which is not exactly the same as spinal manipulation. The intent is very different. A separate article for scientifically justified Spinal manipulation is needed. MDs and PTs do not manipulate for the purpose of removing non-existent chiropractic vertebral subluxations, which is the chiropractic justification for using "adjustments." -- Fyslee 05:27, 23 August 2006 (UTC)

[edit] From Manipulation article

In the context of joints, manipulation is the skilled passive movement of a joint that is applied at varying speeds and amplitudes, including a small-amplitude/high velocity therapeutic movement or thrust. It can also refer to the process of bringing fragments of fractured bone or displaced joints into normal anatomical alignment (otherwise known as 'setting' the bone).

Manipulation does not imply specificity or the correction of the chiropractic subluxation, and therefore is not entirely synonymous with the chiropractic adjustment. -- Fyslee 20:31, 3 September 2006 (UTC)

[edit] POV issues

There are big issues in this article, most notably the recent dominant inclusions from Edzard Ernst who is not a specialist or expert in manipulation/chiropractic and the overall bad tone of the safety section, POV issues with attribution to chiropractic "strokes" when DCs were not involved as well as the underreporting which is challenged in physical med journals. Furthermore, there are major omissions in recent papers which have studied the stroke issue in depth by experts in SMT and stroke. CorticoSpinal (talk) 23:13, 25 April 2008 (UTC)

We disagree as to what the POV problems are. That's OK. What's not OK is your unsourced assertion that 90% of spinal manipulations are performed by chiropractors, even if you restrict yourself to manipulations in which the practitioner is trained. — Arthur Rubin (talk) 04:01, 26 April 2008 (UTC)

Before we begin, I just want to confirm that you're really the Arthur Rubin, mathematician extraordinaire, right? Good, now we've noted that, I would like to remind of you of a little something, I urge you to look at the scope of the article. Do you see that medical stub there? Well, that falls under my domain, my expetise. My expertise is chiropractic medicine and spinal manipulation is the characteristic treatment. Admin Baegis had some very good advice which he opined "If you struggled with passing calculus, don't go mucking about with the taylor series article.". That's some good advice, methinks.

So, here is the source you wanted, (there are more) and it is considered the authoritative source whose chapter on SMT alone would be extremely beneficial to include with the plethora of research into the neurophysiologal responses and proposed theories too. After all, chiropractors are the expert providers of spinal adjustment, manipulation and manual therapy. There are also tons more to add to the article from a scientific, cultural and historical POV whilst also addressing some severely biased POV issues. Here's another: Can you please explain to me rationally why this section here on further reading consists of texts from 2 MDs, 5 PTs, and 0 DCs. Because that seems rather odd when you factor than 90% of spinal manipulations are performed by DCs. Looking forward to working with you. CorticoSpinal (talk) 07:15, 26 April 2008 (UTC)

In the absence of evidence to the contrary, that seems a valid source for the statement, but please include the source. However, only (some) chiropractors understand the difference (if any) between spinal manipulation and chiropractic adjustment, so that it is still not the case that the chiropractic POV should dominate this article. Please do not add unsourced statements, but you probably should add more reading material. As an aside, you seem to be suggesting that this article is a POV fork of chiropractic adjustment, and should be merged into that article. I'm not sure I agree with that suggestion, but it seems to be what you are suggesting. — Arthur Rubin (talk) 15:00, 26 April 2008 (UTC)

I think you may be confused, or misinformed, Mr. Rubin. The chiropractic scientists who are publishing the texts are quite clear that SMT is interchangeable with adjustment and this is the position of the majority of the profession. I think you may be referring to the minority position amongst "ultra-straights" who may still carry some metaphysical interpretations; but this is the fringe position within the profession. I also never suggested that chiropractic POV should dominate the article; but they are the experts in manipulation. The article will be scientific; it's a medical procedure (it falls under the wikiproject medicine scope) and I shall bring it up to snuff so that it can become, in time, a FA. CorticoSpinal (talk) 18:17, 26 April 2008 (UTC)

Your editing style looks familiar. Have I worked with you before under another name?

In any case, as you assert that chiropractic adjustment and spinal manipulation are the same topic, you should be supporting merging the articles, before doing serious work updating one or the other.

You haven't said that the chiropractic point of view should dominate the article, but you've said that the scientific point of view should dominate (oddly enough, I disagree — most of the medical discussion of spinal manipulation is not scientific), and that the relevant scientists are chiropractors.

— Arthur Rubin (talk) 18:44, 26 April 2008 (UTC)

To be clear; you disagree the spinal manipulation is a medical procedure that does not have much scientific evidence? What exactly are you disputing here so we can iron out issues before I begin to bring the article up to wikipedia's project medicine standards? Thanks in advance. CorticoSpinal (talk) 19:50, 29 April 2008 (UTC)

Is that a double negative or a triple negative? In any case, I believe that it is not the case that spinal manipulation is a medical procedure which has scientific evidence. Because of disputes originated by chiropractors, it's not clear whether spinal manipulation is the same as chiropractic adjustment, and whether anyone can reliably distinguish between the two without knowing the intent of the practitioner. — Arthur Rubin (talk) 22:31, 29 April 2008 (UTC)

Hi Guys, if I may. It is widely regarded that chiropractors perform approx 90% of manipulations in the US, but not in the world. In fact, in the UK, the majority of manipulations are performed by osteopaths, who outnumber chiropractors by approx 2:1. As WP is a global source of information, I think it would be wise to note the limitations of the 90% statement (specifically that it relates only to the US). By the same token, spinal manipulation is the generic term for the intervention applied by chiropractors, osteopaths, and physiotherapists/physical therapists, etc. If the chiropractic profession insist on claiming that the term 'adjustment' includes other non-manipulation interventions *as they often appear to), then I would be very much against an article merge.Davwillev (talk) 15:29, 30 April 2008 (UTC) BTW, if we are being strict with sources here, we need a better source than a textbook for the 90% claim. This is secondary referencing unless the original piece of research is cited.Davwillev (talk) 15:58, 30 April 2008 (UTC)

I have no problem with changing to North America. The same situation applies in Canada where DCs do 90% of the manips. As for secondary sources, according to a strict interpretation of WP:MEDRS these are preferred; but if you want an actual paper, it's easy enough to fetch. I support the merger of spinal adjustment and manipulation; adjustment (as interpreted by the STRAIGHT DCs) is a subset of spinal manipulation, whereas the MIXERS view it essentially as synonymous with SMT. Waaaaaaaaay too much is being made behind of the 1910's philo of adjustment which is tenuously being guarded by the extreme fringe within the chiropractic profession. It's time to reflect the contemporary POV of manips (by the mainstream of DCs) It seems like people's beliefs system around here could use an adjustment! —Preceding unsigned comment added by CorticoSpinal (talk • contribs) 19:24, May 4, 2008

I've got a problem with that. It still seems improbable to me, and it's not sourced. As for an adjustment of your attitude, as you have been sanctioned for POV edits under another name, the mainstream scientific or medical point of view is what should be used, not the "mainstream" chiropractic point of view. As far as I can tell, the mainstream medical point of view on spinal manipulation is that it is frequently called chiropractic adjustment, but that no one, not even practicing chiropractors, can define the difference. — Arthur Rubin (talk) 17:42, 4 May 2008 (UTC)