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RE: Re: How the Curse of Chiropractic Corrupts the Science s. fuchs dc

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Dr. McLagan,

Just out of curiosity, what did you "replace" the subluxation/malposition/fixation theory with? And, what form of treatment you apply for this "clinical entity."

Thank you.

M. s, D.C.

How the "Curse of Chiropractic" Corrupts the Science s. fuchs dc> > > > I thought this was an interesting article in light of some of our most recent discussions :> > http://www.chiroweb.com/archives/24/23/15.html>

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I don't read it that way at all. VSC is 'complex' that is what I hear and it takes more words than just 'pinched nerve' to explain.

sharron fuchs dc

From: [mailto: ] On Behalf Of Shad McLaganSent: Tuesday, November 14, 2006 3:10 PM Subject: Re: How the "Curse of Chiropractic" Corrupts the Science s. fuchs dc

It seems as if some of you are starting to agree with the fact that the subluxation/malposition/fixation theory do not exist.Shad McLagan D.C.>> Dr. Beebe says: "And really, do we all really believe that there is this large group of crazy, foaming at the mouth DC's who subscribe to the notion that the pinched nerve theory,..."> > DITTO!!> I went to a very straight school and it was understood and explained that the ol kink in the hose theory was for illustration purposes and in reality things were more complex. The article doesn't make much sense frankly. It certainly doesn't offer any MODERN explanations and if one were to believe everything therein, one would also have to negate Accupuncture philosophy and other similar fields.> > Dr. ph Medlin D.C.> Spine Tree Chiropractic> 1627 NE Alberta St. #6> Portland, OR 97211> Ph: 503-788-6800> c: 503-889-6204> How the "Curse of Chiropractic" Corrupts the Science s. fuchs dc> > > > I thought this was an interesting article in light of some of our most recent discussions :> > http://www.chiroweb.com/archives/24/23/15.html>

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Dr. McLagan:

Thank you for finally sharing the

substance behind the initial statement by Dr. Welker. What you state

makes perfect sense. The problem is that you disregard both the possible

presence and importance of addressing the specific mechanical joint

issue. As you can tell I treat from a motion perspective with regards to

joint dysfunction. THIS IS NOT ALL THAT I DIAGNOSE OR TREAT. I was

yelling because it seems you feel that chiropractors who do not approach

problems with your flashlight are all backwoods simpletons. I evaluate

for the presence of soft tissue irritation/injury with many different tests and

various approaches. If it is a strain/sprain, inflamed disc, tendon or

bursa I treat with time tested and successful physical medicine

approaches. If it is fibrosis or adhesions from chronic problems or old

injury I use modalities such as ultrasound and/or deep tissue techniques such

as SASTM (a Graston-like approach). AND IF IT IS JOINT FIXATION OR

RESTRICTION I ADJUST TO RESTORE MOTION. Restrictions in motion are

determined via manual and mechanical means. Just because not all

providers can feel this does not mean it doesn’t exist! I work with

MD’s. I haven’t performed a gyn or prostate exam since

college. I’m not sure I ever felt what I was supposed to. My

brain thought too much and I didn’t experience the true palpatory

experience. The MD’s can’t feel fibrotic lesions in tendon

nor problems with motion. IT’S NOT THEIR JOB. A chiropractors

job is, among other things, to determine the presence (or lack) of the

subluxation complex, or as I term it as it relates to motion, joint dysfunction.

At least that is the way I see it.

I agree that chiropractors need to be a

more unified body of professionals who speak with a common language which is

supportable and understandable. I’m happy that you have found a

rationale and approach which works for you. Just try to be more

respectful of the many who have been down our road before us.

Seitz, DC

Tuality Physicians

730-D SE Oak Street

Hillsboro,

OR 97123

(503)640-3724

From: [mailto: ] On Behalf Of Shad McLagan

Sent: Tuesday, November 14, 2006

6:05 PM

Subject: Re: How the

" Curse of Chiropractic " Corrupts the Science s. fuchs dc

Dr. s

We have replaced the " subluxation/malposition/fixation "

model with

irrition; whether it be from a disc, facet joint, joint capsule,

muscle/lig, etc. Provocation of the area has the highest

interexaminer reliability and is the best indicator of irritation.

Instead of telling my patient they have a subluxation, after

examination (including provocation), I diagnose them according to

their specific area of irritation. This is something that everyone

in the medical profession can agree upon. With provocation we are

able to determine exactly which segment is irritated. The journal's

that Dr. Welker sent showed that provocation has a higher

interexaminer reliability than palpation.

A Doctor of Chiropractic that only treats

subluxation/malposition/fixation will diagnose a patient that has a

capsular tear, disc tear or bulge, facet irritation, etc, with a

subluxation. Instead of treating the " smoke behind the fire " (LLI,

tight muscles, shifted pelvis, anterior head carriage, etc.) we treat

the " fire " (area of irritation causing the " smoke " ). By

treating the

fire, the " smoke " will then disapate naturally.

We treat with manipulation, mobilization, traction, flexion

distraction, along with other modalities, in such a way that it does

not further irritate the body/area/ " fire " , and works with the

body to

decrease the irritation.

In essence it is our examination, diagnosis and treatment that makes

us different. We have a close working relationship with local MD's

(GP, ortho, neuro, physiatrist) and neurosurgical units because they

respect and understand our examination, diagnosis and treatment.

Shad McLagan D.C.

> >

> > Dr. Beebe says: " And really, do we all really believe that

there is

> this large group of crazy, foaming at the mouth DC's who

subscribe to

> the notion that the pinched nerve theory,... "

> >

> > DITTO!!

> > I went to a very straight school and it was understood and

> explained that the ol kink in the hose theory was for

illustration

> purposes and in reality things were more complex. The article

doesn't

> make much sense frankly. It certainly doesn't offer any MODERN

> explanations and if one were to believe everything therein, one

would

> also have to negate Accupuncture philosophy and other similar

fields.

> >

> > Dr. ph Medlin D.C.

> > Spine Tree Chiropractic

> > 1627 NE Alberta St.

#6

> > Portland, OR 97211

> > Ph: 503-788-6800

> > c: 503-889-6204

> > How the " Curse of Chiropractic "

Corrupts

the

> Science s. fuchs dc

> >

> >

> >

> > I thought this was an interesting article in light of some of

our

> most recent discussions :

> >

> > http://www.chiroweb.com/archives/24/23/15.html

> >

>

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Has nothing to do with it Shad.

Again, "starting" to agree would insenuate that you and your cohorts have introduced a new phenomenon. This is false and has been topic of discussion for a very long time.

ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211

How the "Curse of Chiropractic" Corrupts the Science s. fuchs dc> > > > I thought this was an interesting article in light of some of our most recent discussions :> > http://www.chiroweb.com/archives/24/23/15.html>

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Thank you Shad for clarifying what was a VERY nebulous and confrontational attempt by your colleague Dr. Welker. I believe that we are splitting hairs here though. Many of us if not most treat sililarily. Once you fix the area of irritation, i'd argue that rehab of the affected structures should be implemented ie postural reforamation techniques, rehab exercises etc. Your explanation of Irritation/provocation i don't think can be completely separated from palpation. How are you to provoke without palpation and if you do why would you not palpate afterwords? Palpation by the way is a standard in Physical Examination not just a chiropractic entity and Orthopedic testing which is definitely provacational has pretty low reliability as well.

BTW, a close working relationship with those you describe does not by any stretch put you above the chiropractors who practice differently and certainly doesn't indicate that you are somehow a superior chiropractic practice. Simply more like them. You can call a rose by any other name and yet it remains a rose.

ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211

How the "Curse of Chiropractic" Corrupts the > Science s. fuchs dc> > > > > > > > I thought this was an interesting article in light of some of our > most recent discussions :> > > > http://www.chiroweb.com/archives/24/23/15.html> >>

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Just think,

It took 150 junk emails to make that

statement.

Kehr DC

From:

[mailto: ] On Behalf

Of Shad McLagan

Sent: Tuesday, November 14, 2006

6:05 PM

Subject: Re: How the

" Curse of Chiropractic " Corrupts the Science s. fuchs dc

Dr. s

We have replaced the " subluxation/malposition/fixation "

model with

irrition; whether it be from a disc, facet joint, joint capsule,

muscle/lig, etc. Provocation of the area has the highest

interexaminer reliability and is the best indicator of irritation.

Instead of telling my patient they have a subluxation, after

examination (including provocation), I diagnose them according to

their specific area of irritation. This is something that everyone

in the medical profession can agree upon. With provocation we are

able to determine exactly which segment is irritated. The journal's

that Dr. Welker sent showed that provocation has a higher

interexaminer reliability than palpation.

A Doctor of Chiropractic that only treats

subluxation/malposition/fixation will diagnose a patient that has a

capsular tear, disc tear or bulge, facet irritation, etc, with a

subluxation. Instead of treating the " smoke behind the fire " (LLI,

tight muscles, shifted pelvis, anterior head carriage, etc.) we treat

the " fire " (area of irritation causing the " smoke " ). By

treating the

fire, the " smoke " will then disapate naturally.

We treat with manipulation, mobilization, traction, flexion

distraction, along with other modalities, in such a way that it does

not further irritate the body/area/ " fire " , and works with the

body to

decrease the irritation.

In essence it is our examination, diagnosis and treatment that makes

us different. We have a close working relationship with local MD's

(GP, ortho, neuro, physiatrist) and neurosurgical units because they

respect and understand our examination, diagnosis and treatment.

Shad McLagan D.C.

> >

> > Dr. Beebe says: " And really, do we all really believe that

there is

> this large group of crazy, foaming at the mouth DC's who

subscribe to

> the notion that the pinched nerve theory,... "

> >

> > DITTO!!

> > I went to a very straight school and it was understood and

> explained that the ol kink in the hose theory was for

illustration

> purposes and in reality things were more complex. The article

doesn't

> make much sense frankly. It certainly doesn't offer any MODERN

> explanations and if one were to believe everything therein, one

would

> also have to negate Accupuncture philosophy and other similar

fields.

> >

> > Dr. ph Medlin D.C.

> > Spine Tree Chiropractic

> > 1627 NE Alberta St.

#6

> > Portland, OR 97211

> > Ph: 503-788-6800

> > c: 503-889-6204

> > How the " Curse of Chiropractic "

Corrupts

the

> Science s. fuchs dc

> >

> >

> >

> > I thought this was an interesting article in light of some of

our

> most recent discussions :

> >

> > http://www.chiroweb.com/archives/24/23/15.html

> >

>

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Share on other sites

Interesting take on this issue, Shad. My take is that we understand the 'crimp in the hose' is a concept but the segmental dysfunction concept influencing pain IS understood.

Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: "Shad McLagan" <shadmac11@...> Subject: Re: How the "Curse of Chiropractic" Corrupts the Science s. fuchs dcDate: Tue, 14 Nov 2006 23:09:46 -0000

It seems as if some of you are starting to agree with the fact that the subluxation/malposition/fixation theory do not exist.Shad McLagan D.C.>> Dr. Beebe says: "And really, do we all really believe that there is this large group of crazy, foaming at the mouth DC's who subscribe to the notion that the pinched nerve theory,..."> > DITTO!!> I went to a very straight school and it was understood and explained that the ol kink in the hose theory was for illustration purposes and in reality things were more complex. The article doesn't make much sense frankly. It certainly doesn't offer any MODERN explanations and if one were to believe everything therein, one would also have to negate Accupuncture philosophy and other similar fields.> > Dr. ph Medlin D.C.> Spine Tree Chiropractic> 1627 NE Alberta St. #6> Portland, OR 97211> Ph: 503-788-6800> c: 503-889-6204> How the "Curse of Chiropractic" Corrupts the Science s. fuchs dc> > > > I thought this was an interesting article in light of some of our most recent discussions :> > http://www.chiroweb.com/archives/24/23/15.html>

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Well, ignoring the generalizations you make about subluxation based Chiropractors, I don't think too many people would have any argument about treating "irritation" and using "provocation" in order to find it!

Motion palpation, along with most other ortho/neuro tests, relies on positive "provocation" in order to be considered a positive test (if I'm not mistaken).

But, that aside... How do you diagnose/treat a "non-inflammatory" or "non-acute" neck or low back condition? For example, the patient who has had no recent trauma, comes in simply because their neck feels tight, they get occasional headaches, they hear crunching/grinding in their neck with movement, and/or their low-back aches every morning, and let's up once they're up moving around?

Thanks!

RR.

How the "Curse of Chiropractic" Corrupts the > Science s. fuchs dc> > > > > > > > I thought this was an interesting article in light of some of our > most recent discussions :> > > > http://www.chiroweb.com/archives/24/23/15.html> >>

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Shad,

Just got 2 referrals from Kaiser.

The first diagnosis was

low back pain (724.2) [their words].

Excellent interexaminer reliability and indicator of irritation.

In my simpleness, I thought that low back pain was a finding, not a diagnosis.

Second patient diagnosed with cervicalgia (723.1)

Same argument.

Now I don’t know what to do.

Kaiser only pays for chiropractors to adjust spinal subluxations.

Please help (sarcasm intended).

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

From: Shad McLagan <shadmac11@...>

Date: Wed, 15 Nov 2006 02:04:55 -0000

< >

Subject: Re: How the " Curse of Chiropractic " Corrupts the Science s. fuchs dc

Dr. s

We have replaced the " subluxation/malposition/fixation " model with

irrition; whether it be from a disc, facet joint, joint capsule,

muscle/lig, etc. Provocation of the area has the highest

interexaminer reliability and is the best indicator of irritation.

Instead of telling my patient they have a subluxation, after

examination (including provocation), I diagnose them according to

their specific area of irritation. This is something that everyone

in the medical profession can agree upon. With provocation we are

able to determine exactly which segment is irritated. The journal's

that Dr. Welker sent showed that provocation has a higher

interexaminer reliability than palpation.

A Doctor of Chiropractic that only treats

subluxation/malposition/fixation will diagnose a patient that has a

capsular tear, disc tear or bulge, facet irritation, etc, with a

subluxation. Instead of treating the " smoke behind the fire " (LLI,

tight muscles, shifted pelvis, anterior head carriage, etc.) we treat

the " fire " (area of irritation causing the " smoke " ). By treating the

fire, the " smoke " will then disapate naturally.

We treat with manipulation, mobilization, traction, flexion

distraction, along with other modalities, in such a way that it does

not further irritate the body/area/ " fire " , and works with the body to

decrease the irritation.

In essence it is our examination, diagnosis and treatment that makes

us different. We have a close working relationship with local MD's

(GP, ortho, neuro, physiatrist) and neurosurgical units because they

respect and understand our examination, diagnosis and treatment.

Shad McLagan D.C.

> >

> > Dr. Beebe says: " And really, do we all really believe that

there is

> this large group of crazy, foaming at the mouth DC's who

subscribe to

> the notion that the pinched nerve theory,... "

> >

> > DITTO!!

> > I went to a very straight school and it was understood and

> explained that the ol kink in the hose theory was for

illustration

> purposes and in reality things were more complex. The article

doesn't

> make much sense frankly. It certainly doesn't offer any MODERN

> explanations and if one were to believe everything therein, one

would

> also have to negate Accupuncture philosophy and other similar

fields.

> >

> > Dr. ph Medlin D.C.

> > Spine Tree Chiropractic

> > 1627 NE Alberta St. #6

> > Portland, OR 97211

> > Ph: 503-788-6800

> > c: 503-889-6204

> > How the " Curse of Chiropractic " Corrupts

the

> Science s. fuchs dc

> >

> >

> >

> > I thought this was an interesting article in light of some of

our

> most recent discussions :

> >

> > http://www.chiroweb.com/archives/24/23/15.html

> >

>

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Share on other sites

Dr. McLagan said, "In essence it is our examination, diagnosis and treatment that makes us different. We have a close working relationship with local MD's (GP, ortho, neuro, physiatrist) and neurosurgical units because they respect and understand our examination, diagnosis and treatment."

In response Dr. Medlin stated, "BTW, a close working relationship with those you describe does not by any stretch put you above the chiropractors who practice differently and certainly doesn't indicate that you are somehow a superior chiropractic practice. Simply more like them. You can call a rose by any other name and yet it remains a rose."

This is an excellent point. I think most of us who have been in the field "a while now" :) have treated medical doctors, nurses, dentists, PT's, acupuncturists, LMT's and/or naturopaths (I have personally treated persons from each of these professions). DOESN'T MAKE ME A BETTER CHIROPRACTOR!

We receive referrals from MD's and neuro's (not much from the Orthos, though! ;) and, again, no big deal...

Medical persons are just like the general public. They really have no "formal training" in Chiropractic. Some get it, like it, use it. Some don't.

It doesn't make what we do anymore "right or wrong" based upon who our patients are, or who refers to us. Just because I treat Madonna, doesn't make me better...(ok that was a joke...treating Madonna WOULD make me better :)

Personally, I feel more "validated" by the patient who pay 100% cash out-of-pocket. That's a true testament! I suggest that if we were to take insurance away tomorrow, every doctor out there (except the "cash practice" chiropractors :) would experience a rude awakening as to the "real value" our patients place in us.

RR. (good posts, though, doctors).

How the "Curse of Chiropractic" Corrupts the > Science s. fuchs dc> > > > > > > > I thought this was an interesting article in light of some of our > most recent discussions :> > > > http://www.chiroweb.com/archives/24/23/15.html> >>

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You document it just as you did right here .... write up what they say....we all know that is the beginning of a suluxation pattern ... write what they say, add the positive tests you find and do your magic!

Sunny ;'-))

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: " M. s, D.C." <drbobdc83@...>< >Subject: Re: Re: How the "Curse of Chiropractic" Corrupts the Science s. fuchs dcDate: Wed, 15 Nov 2006 10:14:20 -0800

Well, ignoring the generalizations you make about subluxation based Chiropractors, I don't think too many people would have any argument about treating "irritation" and using "provocation" in order to find it!

Motion palpation, along with most other ortho/neuro tests, relies on positive "provocation" in order to be considered a positive test (if I'm not mistaken).

But, that aside... How do you diagnose/treat a "non-inflammatory" or "non-acute" neck or low back condition? For example, the patient who has had no recent trauma, comes in simply because their neck feels tight, they get occasional headaches, they hear crunching/grinding in their neck with movement, and/or their low-back aches every morning, and let's up once they're up moving around?

Thanks!

RR.

How the "Curse of Chiropractic" Corrupts the > Science s. fuchs dc> > > > > > > > I thought this was an interesting article in light of some of our > most recent discussions :> > > > http://www.chiroweb.com/archives/24/23/15.html> >>

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