March 2010 Health Newsletter

For the first time in the history of the Olympic Games, the 2010 Winter Games in Vancouver, Canada, include chiropractic care inside the Olympic Village Polyclinic, a multi-disciplinary facility offering comprehensive healthcare and medical services.

While DCs have historically been included on the Olympic medical staff, this year’s events mark the first time that DCs from the host country will be treating athletes and officials from around the world directly inside the Polyclinic.

“This is an historic event not only for the chiropractic profession, but also the athletes who will now have access to the care that will help them prepare their bodies for competition,” states Michael Reed, DC, MS, DACBSP, and team USA’s medical director (USOC). “These athletes train hard and endure significant physical demands. Sports-focused DCs, along with other members of the sports medicine team, are specially skilled to assist them in reaching peak performance.”

Chiropractic care has experienced several major moments in Olympic history, dating back to Leroy Perry, DC, who provided chiropractic care to athletes representing Antigua during the 1976 Games in Montreal, Canada. During the 1980 Winter Olympic Games in Lake Placid, NY, George Goodheart, DC, became the first official chiropractor appointed to the U.S. team.

With each subsequent Olympic Games and Pan American Games, the U.S. teams — along with a growing number of other national teams — have included at least one doctor of chiropractic on their medical staff.

“Inclusion inside the Polyclinic is another major milestone for the chiropractic profession, and we are grateful to the host city of Vancouver, the head of medical services at the Polyclinic, Jack Taunton, MD, and to Robert Armitage, DC, who helped make this possible,” says USOC Director of Sports Medicine Clinics, Bill Moreau, DC, DACBSP.

A recent survey involving 963 college students indicates the college lifestyle is strongly associated with back pain. Of those surveyed, 38 percent or almost 4 in 10 students reported having suffered from back pain within the previous school year. Interestingly, the strongest associations with back pain in college students were the students either feeling chronically fatigued or being in an emotionally abusive relationship. Thus, survey findings indicated psychosocial factors were highly associated with a student’s likelihood of suffering from back pain.

“The most recent research (Neck Pain Task Force Report of the Bone and Joint Decade 2000-2010, a study sanctioned by the United Nations and the World Health Organization) indicates neck manipulation is a safe and effective form of health care,” according to Matt Pagano, DC, chiropractic profession spokesperson.

Respected researcher and epidemiologist J. David Cassidy, DC, PhD, DrMedSc, testified as a key witness last week at the hearings on informed consent before the Connecticut Board of Chiropractic Examiners in Hartford, Conn. Speaking as an expert witness and consultant to the International Chiropractors Association (ICA)—and with the support of all chiropractic organizations involved in the process, including the American Chiropractic Association, Association of Chiropractic Colleges, Foundation for Chiropractic Progress, Life West, New York College of Chiropractic, Parker College of Chiropractic, Palmer College of Chiropractic, and the University of Bridgeport College of Chiropractic—Dr. Cassidy addressed key facts and issues on the basis of the existing science and research record, to which he has been a significant contributor. The objective of his testimony was to bring the discussion from an emotional issue back to science and the objective research record.    

Dr. Cassidy joined an extensive list of witnesses representing the chiropractic profession, including William J. Lauretti, DC; James J. Lehman, DC, MBA; J. Clay McDonald, DC, JD, MBA; Gerard W. Clum, DC; Stephen M. Perle, DC, MS; Gina Carucci, DC, MS, DICCP, who appeared on behalf of the Connecticut Chiropractic Association (CCA); and George Curry, DC, FICA, who appeared on behalf of the Connecticut Chiropractic Council (CCC).  

“The chiropractic profession unequivocally supports a patient’s right to be informed of the material benefits and risks of any type of health care treatment – not just chiropractic. Legislation or regulatory mandates governing informed consent should apply to all health care providers and all treatments in equal measure. However, a new law, regulation or mandate highlighting one specific treatment by a specific health care profession, which carries with it an extremely rare association and no causal link identified in the research, is simply not good public health policy. It would set an unnecessary precedent for all health care providers, procedures and products that would be virtually impossible to implement,” said Pagano.

The existing informed consent standards in Connecticut allow for the best opportunity for shared decision making between a patient and his or her health care provider. Further, the chiropractic organizations participating in the hearing process all believe informed consent is more than a piece of paper; it is a process. It should occur in the context of a discussion between a doctor and a patient, and it should be appropriately documented.

In a finding highly relevant to the issue before the Connecticut Board of Chiropractic Examiners, the Neck Pain Task Force study demonstrated that patients suffering from headache and neck pain are no more likely to suffer from a stroke following a visit to a chiropractor than they are after a visit to a family medical physician. This implies that there are factors involved other than the type of care provided by doctors of chiropractic.  It’s important to note that millions of patients safely benefit from chiropractic care every year—they are able to return to their normal activities and enjoy a better quality of life.

Dr. Cassidy was an investigator with the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The work of this international task force affirms the safety and benefits of chiropractic care for people with neck pain—a condition frequently treated by doctors of chiropractic. The Task Force initiated this new population-based, case-control and case-crossover study, which appeared in the Feb. 15, 2008 edition of the journal Spine. 



The study, which analyzed nine years’ worth of data from a population of 110-million person years, concluded that vertebrobasilar artery (VBA) stroke is a very rare event and that the risk of VBA stroke following a visit to a chiropractor’s office appears to be no different than the risk of VBA stroke following a visit to the office of a primary care medical physician (PCP). 
 
The study goes on to say that any observed association between VBA stroke and chiropractic manipulation—as well as its apparent association with PCP visits—is likely due to patients with an undiagnosed vertebral artery dissection seeking care for neck pain and headache prior to their stroke.
 


Over the years, popular media has all too often sensationalized the association between chiropractic cervical manipulation and cerebral vascular accidents—even though the evidence would strongly indicate that this assertion is incorrect. The organizations representing the chiropractic profession believe this most recent evidence should help to dispel any myths on this issue, as well as provide more data to support the safety and effectiveness of chiropractic procedures.
 


As a profession, doctors of chiropractic remain committed to expanding the research and clinical understanding of VBA injuries, because even one cerebral vascular incident that could have been prevented or detected early is one too many.

A new report indicates U.S. hospitals for many are a potentially deadly place. According to the report, 48,000 patients in 2006 were killed in U.S. hospitals from pneumonia and blood-borne infections acquired during the patients’ hospital stay. This amounted to approximately $8.1 billion in medical costs. According to researcher Anup Malani, “In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control and they can die.” Overall, it is estimated that 1.7 million healthcare-associated infections are diagnosed every year in the United States.