Journal of Manipulative and Physiological Therapeutics

A Look in the Mirror: A Critical and Exploratory Study of Public Perceptions of the Chiropractic Profession in the State of New Jersey
Jose E. Sanchez, Ph.D.

Abstract:

This paper reports the results of a telephone survey of 693 respondents, commissioned by the New Jersey Chiropractic Society. This exploratory study provides a broad-ranging and critical view of the profession which examines several key aspects relating to the chiropractic profession as it is practiced in New Jersey. The study concludes that chiropractic in New Jersey is still a viable means of treating various disorders, but there remains much confusion and distrust among prospective and current patients as well as the threat of heightened competition from other health professionals. The findings indicate that chiropractic must develop clear boundaries around the number and extent of the conditions it can treat and must substantiate its claims with valid clinical trials. A research-based education campaign was found to be necessary if the discipline is to encourage non-users to become users. The most powerful vehicle for influencing public opinion and the number of referrals was found to be family and friends. The findings also indicate that comparisons with medical doctors can backfire, making the "chiropractic physician" (the professional label preferred by most respondents) less qualified by comparison. Rather than reject the paradoxical nature of their role as primary care physicians and specialists in spine-related disorders, chiropractors should embrace this uniqueness and establish themselves as an integral component of the health care network. Clearer boundaries, a grounding in scientific clinical research and better interprofessional relations can insure continued growth and success in this state.

Abstract:

This paper reports on a case-control study of 201 randomly selected disabling low back workers' compensation cases. To control claim severity prior to comparison studies on time loss and treatment cost, a classification scheme based on documented clinical signs and symptoms was used to subgroup the claims from two provider groups, chiropractic (DC) and medical (MD), into three categories of clinical presentation. Soft tissue strain/sprain predominated in both provider groups. The two provider groups differed in the proportion of claimants with physical factors contributory to low back compromise. DC claimants were less likely than MD claimants to have sought initial treatment in the emergency room, more likely to have a history of chronic, recurrent low back pain, and more likely to have suffered exacerbation episodes suggesting a greater level of chronicity among chiropractic claimants.

Abstract:

This study assesses changes in the mechanics of walking for sacroiliac joint patients when (a) wearing an intertrochanteric support belt (Power Belt), (b) wearing an intertrochanteric support belt in a placebo position, and (c) not wearing a support belt at all. The mechanics of walking was assessed by measuring the ground reaction forces during the support phase of gait, using a force-platform (Kistler Inc.). The results obtained did not show clear differences of the walking patterns between the three experimental situations. However, some tendencies were observed which led to the speculation that the intertrochanteric support belt may restrict motion in the sacroiliac joint.

Abstract:

Gross dissection anatomical studies have investigated the course of the human lumbar posterior primary ramus and its branches. This nerve has frequently been associated with low back pain; however, the cross-sectional area of the space beneath the mamillo-accessory ligament, which is occupied by the medical branch of the posterior primary ramus, has not been clearly defined. The purpose of this study is to use a histological procedure to identify the cross-sectional area of the space beneath the mamillo-accessory ligament, which is occupied by the medical branch of the posterior primary ramus as it passes en route to the zygapophyseal joint capsules. The main finding is that the medical branch of the posterior primary ramus occupies only a small percentage (approximately 3%) of the space enclosed by the mamillo-accessory ligament and that it is surrounded by adipose tissue which provides an adequate protective "cushion" around it. Therefore, it is unlikely that the medical branch of the posterior primary ramus could be trapped beneath the mamillo-accessory ligament and cause pain.

Abstract:

A new method for assessing cervicogenic vertigo is presented. This method can quickly assess patient status regarding the origins of vertigo. Preliminary data on 235 patients found that 112 (47.6%) were positive to the tests. After 18 treatments, 101/112 (90%) of the patients were symptom free. The patients responding best suffered acute upper cervical joint problems, along with muscle trauma in that region. The neurophysiology of the area is reviewed so that the mechanisms and the tests are understood.