Chiropractic Insights

Christopher Kent

Description

Chiropractic Insights is a collection of essays, covering a variety of topics, including philosophy, politics, education, research, and other issues of interest to the chiropractic profession.

Sujets

• Holism
• Health
• Fitness

Informations

• Publié par: eBookIt.com
• Date de parution: 18 juillet 2013
• Nombre de lectures: 0
• EAN13: 9781456618322
• Langue: English

Extrait

Chiropractic
Insights
__________
 
Christopher Kent, D.C., Esq.

Copyright 2013 Christopher Kent D.C., Esq.,
All rights reserved.
 
 
Published in eBook format by eBookIt.com
http://www.eBookIt.com
 
 
ISBN-13: 978-1-4566-1832-2
 
 
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means without written permission from the author.

Dedication
To my godson Connor, and my nephews Jonathan, Jordan, and Justin.
Introduction and Attribution
Chiropractic Insights is a collection of essays, all but one of which (Chapter 40) was originally published in Dynamic Chiropractic . The date range is from 2001 through 2013. These essays cover a variety of topics, including philosophy, politics, education, research, and other issues of interest to the chiropractic profession. The author extends thanks to Dynamic Chiropractic for permission to publish this compilation.
 
Each essay stands alone. The reader can make productive use of limited time by reading an essay.
Chapter One
Healing From Within: The Power of You
 
A growing body of research suggests patient and practitioner attitude, intent and emotions can influence clinical outcomes.
 
A quiet revolution is gaining momentum in spine science: The biopsychosocial model is challenging the simplistic biomedical model.
 
Instead of limiting the perspective of the clinician to an identifiable pathology, the biopyschosocial model emphasizes that one should consider "the patient's unique biologic, psychological, social, and economic milieu." 1
 
Recent publications are taking things to a higher level. An article titled "The Power of Suggestion – A Wild Card Across Spine Care" states, "The power of suggestion – and corresponding patient/subject expectations regarding outcomes – can have major effects in spinal medicine and spinal research ... simply observing people, paying attention to them, or making them feel special can induce powerful effects." 2 A paper by Michael and Garry 3 suggests that suggestion and expectation may affect other well-known findings.
 
Scientists are also studying the relationship between emotions, brain connectivity, and pain. A study reported that where pain persisted, brain gray matter density decreased. The authors also noted, "Initially greater functional connectivity of nucleus accumbens with prefrontal cortex predicted pain persistence, implying that corticostriatal circuitry is causally involved in the transition from acute to chronic pain." 4 And as reported in the U.K.'s The Telegraph, "The more emotionally the brain reacted to the initial injury, the more likely it was that pain [would] persist after the injury [had] healed." 5
 
A frequent question asked by patients and practitioners is, "To what extent do intent, attitude and touch affect health outcomes?" Although these issues may seem unrelated to the technical aspects of health care, a growing body of evidence suggests that such factors may significantly affect the healing process. Attitude matters. Laughter and humor have been shown to have beneficial health effects as well.
 
CBS News 6 reported on a paper in Aging 7 that examined personality traits in people 95 years of age and older. The researchers reported that most had positive personality traits; the majority were outgoing, optimistic and easygoing. As noted by CBS News, "They considered laughter an important part of life and had a large social network. They expressed emotions openly rather than bottling them up." Other investigators have found that dispositional optimism protects older adults from strokes. 8-9
 
Berk, et al., 10 investigated how humor-associated, mirthful laughter modulated certain neuroimmune parameters. Fifty-two healthy men participated in the study. Blood samples were taken 10 minutes before viewing an hour-long humor video. Additional blood samples were taken 30 minutes into the video, 30 minutes after the viewing was completed and 12 hours after the viewing. Increases were found in natural killer cell activity (immunoglobins G and M), with several immunoglobin effects lasting 12 hours after viewing the humor video.
 
Other effects lasting at least 12 hours were increases in leukocyte subsets and cytokine interferon gamma. The authors concluded, "Modulation of neuroimmune parameters during and following the humor-associated eustress [pleasant or curative stress] of laughter may provide beneficial health effects for wellness."
 
Finally, in a study by Kimata, 11 allergy patients who watched a Charlie Chaplin comedy had their skin welts shrink, an effect not found in control subjects who watched weather reports.
 
Do these studies mean that practitioners should abandon our clinical procedures and become stand-up comics? Certainly not! However, realize that an upbeat, positive, empathic attitude will benefit your practice members more than a neutral or negative one. In a study by DiBlasi, et al., 12 the authors stated, "One relatively consistent finding is that physicians who adopt a warm, friendly, and reassuring manner are more effective than those who keep consultations formal and do not offer reassurance."
 
As chiropractors, we touch our patients and project an attitude that profoundly affects their well-being. We can do so by default or by design. My message to practitioners and patients alike is to focus on your intent to allow the body to express its potential. It may significantly affect clinical outcomes.
References
 
1. Weiner BK. Spine update: the biopsychosocial model and spine care. Spine, 2008;15;33(2):219.
2. The Power of Suggestion - A Wild Card Across Spine Care. The Back Letter, 2012;27(8);96.
3. Michael RB, Garry M. Suggestion, cognition, and behavior. Current Directions in Psychological Science, 2012;21(3):151.
4. Balioki MN, Petre B, Torbey S, et al. Corticostriatal functional connectivity predicts transition to chronic back pain. Nature Neuroscience, 2012;15:1117.
5. Chronic Pain Is Determined by Emotions, Scientists Believe. The Telegraph (UK), July 1, 2012.
6. Castillo M. Researchers Discover Optimism May Lead to Longevity. CBS News, May 30, 2012.
7. Kato K, Zweig R, Barzilai, Atzmon G. Positive attitude towards life and emotional expression as personality phenotypes for centenarians. Aging, 2012;4(5):359.
8. Smile a Lot; It Just Might Save Your Life. USA Today, Dec. 27, 2011.
9. Kim ES, Park N, Peterson C. Dispositional optimism protects older adults from stroke. AHA Stroke; published online before print July 21, 2011.
10. Berk LS, Felten DL, Tan SA, et al. Modulation of neuroimmune parameters during the eustress of humor-associated mirthful laughter. Alternative Therapies, 2001;7(2):62.
11. Kimata H. Effect of Humor on Allergen-Induced Wheal Reactions. (letter) Journal of the American Medical Association, 2001;285(6):738.
12. DiBlasi Z, Harkness E, Ernst E, et al. Influence of context effects on health outcomes: a systematic review. The Lancet, 2001;357(9258):757.
Chapter Two
Body, Mind and Chiropractic
 
The scope of chiropractic is as broad as the scope of influence of the nervous system. Although many chiropractors tend to focus on disorders associated with the physical body, particularly musculoskeletal pain syndromes, abnormal nervous system function may also affect emotional and psychological health.
 
Research is providing chiropractors with information about how the stress response is mediated by the autonomic nervous system 1 and how afferent input from the spine affects brain function. 2-3
 
Rome published a two-part series reviewing neurovertebral influence on visceral and autonomic function. 4-5 This is the most comprehensive review I have seen on the topic, featuring more than 1,100 references. Rome notes: "Attempts have been made to classify conditions addressed by spinal manipulation into Type M (musculoskeletal) and Type O (organic). However, it seems that this is the only area in the health sciences where such a classification has been suggested. If categorization is necessary at all, then virtually all conditions should be basically 'Type N' (neurological) as nominated by Leach, as essentially all conditions would have a neurological element ... the weakness of a Type M/Type O classification renders it superfluous, if not meaningless. A 'Type N' designation would highlight the importance of total body considerations in such an extensive and integrated model of health care, as well as the encompassing influence and the integrative action of the nervous system."
 
Among Rome's conclusions: "It is the emphasis on a localized ANS connection with the spine which would differentiate the chiropractic health care profession from others in the manipulative and manual therapies field. It must be appreciated that this association implies more than a musculoskeletal connection, and thereby may have the potential to influence neurophysiology and consequently homeostasis, which could contribute to overall patient well-being." 5
 
There is a small, but growing body of evidence concerning the relationship of the spine, vertebral subluxation, chiropractic care, and psychological and emotional health. The following sampling is not a comprehensive review; it is merely to whet your appetite on the subject. A systematic review examined psychological outcomes in randomized controlled trials of spinal manipulation. The study concluded: "There was some evidence that spinal manipulation improved psychological outcomes compared with verbal interventions ... The clinical implications are that physical treatments, such as spinal manipulation have psychological benefits." 6
 
Genthner, et al., 7 reported on a series of 15 patients with a history of depression. The Beck Depression Inventory II was used to measure the baseline level of depression and any post-care changes following orthospinology care. A paired t-test demonstrated significant improvement in depre