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Clarifying Article on Australian Medical Association

Dear Editor,

While I'm excited to see this article published ("Australian Medical Association Taken to Task" DC, Jan. 26, 1999), I must correct an inaccuracy. The Australia Competition & Consumer Commission (ACCC) cannot force the AMA to publish a statement. The fact is that the ACCC requested of the AMA that it publish the article as it appeared in the ACCC Journal -- the AMA refused. As a consequence, the ACCC published the article itself. This in effect puts the AMA on notice that the ACCC will prosecute the AMA for future breaches of the Trade Practices Act as related to interprofessional dealing with chiropractors.

I write with some authority because I have been intimately involved with this case since its inception in 1988.

J. Keith Simpson, BA(Hons),DC
Chair, Trade Practices Committee
Chiropractors' Association of Australia
(National) Limited

Dear Editor:

I'm sorry to say that after reading "Dr. Daniel Cherkin Responds to Critiques of His NEJM Study" (DC, December 14, 1998), I'm left with an even less favorable opinion of the study than I had.

Would Dr. Cherkin's first argument be so, then his initial study should have been renamed "Medical Failure of Patients with One Week of Back Pain: Should We Try Chiropractic or McKenzie?" It could just as well have been called "Washington State: Rationale for allowing PT as an Ancillary Procedure to Chiropractic." This was, of course, not the case. Dr. Cherkin, for some questions, has sound answers for what I would safely say is an inadequate study.

Once again, this leaves us in our usual position as chiropractors, with investigators presenting the world with some questionable information, coming to our defense having to circle our wagons and being left once the dust settles with the same old saw, "Well, gee, if it works for them, it should be OK. It is certainly not backed by sound scientific evidence." This had been our lot for more than 100 years.

As in most situations in life, my first question is, "What is the intent of this effort? Dr. Cherkin says that his initial initent was to see if chiropractic or McKenzie exercise would benefit someone who "failed one week of medical care." I am not convinced of that effort.

Second, and this is on a personal note, having been in practice for many years, I am aware that in the past, Dr. Cherkin and Dr. Deyo have been involved in several studies that seemed favorable to the practice of chiropractic. I wonder if the intent of this article was for Dr. Cherkin to make a break from such a stigma possibly associated with his name in medical circles.

I hope once again that we keep all venues open and that in the future more on the true nature of chiropractic practice (not just nine side posture treatments) is evaluated. Perhaps in a broader sense, our profession would be more involved in the scientific writing of such papers.

Richard W. Beck, DC
Danbury, Connecticut

Dear Editor:

In response to Dr. Michael Cocilovo's letter (see "We Get Letters," DC, Dec, 14, 1998) expressing concern and outrage at the advice from medical columnist Paul Donohue for the condition torticollis (cervical dystonia), I, through personal experience and grave disappointment, must stand on the side of Dr. Donohue. I also question whether or not Dr. Cocilovo has ever treated a case of true torticollis. I'm not talking about "wry neck," which presents as acute cervical pain, muscle spasm and restriction of movement which can also be called torticollis. This type of torticollis is very responsive to chiropractic adjustments. However, cervical dystonia (torticollis) at best is marginally, if at all, responsive to chiropractic adjustments/procedures.

Four years ago, I received a call from my 68-year-old mother expressing concern that her neck seemed to be moving to the left side and was doing it out of her control. Initially, I was not concerned and figured she was out of adjustment, something I would take care of during her next visit in a few weeks (I live in Georgia, she lives in New York).

To my shock, and despite 20 years of practice experience, I was not prepared for the presentation of my mother's problem: uncontrollable and fairly forceful involuntary movement of the head and neck to the left side. It is only in textbooks that I had seen or read of conditions like this before.

My mother has been to no less than six chiropractors (two of whom are nationally respected in their field); eight neurologists, one neurosurgeon; three physical therapists; and one acupuncturist. She has also tried numerous prescription medicines, Chinese herbal medicine and other forms of nutritional supplementation. We have tried Botox injections and all different forms of exercises and visual stimulation of the brain. I am probably forgetting some things that we have tried, they have been so numerous.

I can say beyond a shadow of a doubt that my mother's condition has done nothing but get worse. Torticollis (cervical dystonia) is not a condition related directly to the vertebral subluxation complex although there may be indirect connections. It appears to be a problem involving the postencephalitic extra pyramidal system of a lesion of the lenticular nucleus.

I am not writing to discredit one doctor over another or one profession over another. This is actually a plea for help. My mother and I have cried together for hours over this situation which appears to be hopeless. The contractions of her neck are so forceful now that they almost keep her head completely rotated to the left with her chin in the downward position. Short of a risky and questionable surgical procedure, we know of nothing else that might help her.

Does anyone out there know of something to successfully help this condition? If you do, please contact me.

Steven Garber, DC
Cartersville, Georgia
Tel: (770) 386-7707
drg@trusted.net