The Zen Corner

Science, Art, and Philosophy of Chiropractic


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Nervoscope

 

Written by: Brooke Preston-Chiropractic Intern at Zen Chiropractic Inc. DBA Zen Healing Center

What is the nervoscope?EDL100_dd.jpg

The nervoscope is a thermal device that provides a comparative measure of small differences in temperature from one side of the skin of the back and paraspinal musculature to the other. Thermocouple instruments such as the nervoscope and delta T consist of two thermal sensors and a housing unit(8). When the sensors are at different temperatures, this causes a movement of the needle on the screen of the device, allowing for objective or measurable heat findings. These objective findings can be used as a part of the chiropractic exam and also reviewed at the end of the visit to show objective, numerical evidence of a change in local body temperature.

Why would this change in heat occur in our patient?
thermal-before1Thermography findings are largely accepted as resulting from changes in underlying blood vascularity(10, 11). There are two main mechanisms that are thought to cause these changes. The first being the production of inflammation and release of inflammatory mediators. Many know the signs of inflammation as swelling, heat, altered movement, redness, and pain. The chiropractor is looking for a combination of these in their exam. In this case, the heat produced by local inflammation is what is being measured by the nervoscope. The second mechanism being the cutaneous axon reflex. This reflex occurs as a result of increased activity of recurrent meningeal, or sinuvertebral, nerve. This nerve innervates the intervertebral disc(8). The intervertebral disc is a piece of fibrocartilage that helps distribute loads to the spine. Due to the cutaneous axon reflex, sweat glands and blood vessels in the skin have altered function at one single level and side of the spine which results in a temperature difference(3, 4, 7, 8, 13).

Is this test reliable?
Handheld devices, common to the chiropractic profession, have been evaluated and shown to give moderate to excellent inter-examiner reliability over short time durations(2, 12). Good intra and inter-rater reliability have been found when scanning the thoracic spine, or middle back, in studies done on the nervoscope, however, these results did not extend to the cervical spine, or neck (1).Scope-1-C7.jpg

In Plaugher’s study to determine the reliability of the practitioner in comparison to themselves and other practitioners, found fair-to-moderate reliability in one area and substantial in another(9). All of the patients in this study were asymptomatic or without symptoms. With the mechanism of heat changes described above it is reasonable to assume that with a test group of symptomatic patients there would be even greater reliability results, however, further testing needs to be done with dual probe instrument thermography to extrapolate any sort of conclusions. In this authors opinion, this particular study’s design would be the model to follow for further studies(9).

Is there controversy with the equipment?
Some have reservations about the utilization of the nervoscope and seek to discredit it, however, it is important to understand the credibility and motives of such voices. One man is Stephen Barrett. The US court system declared that “Stephen Barrett is biased and unworthy of credibility” in the NCAHF v. King case. Originally a psychologist, he was forced to give up his medical license in 1993. However, due to Barrett’s degree, people trust him whether his license was revoked or not. Barrett makes money off of posting inflammatory content tearing down anything that doesn’t match his specific beliefs to his blog, Quackwatch and the blog that he co-authors with a Doctor of Chiropractic, Samuel Homola, Chirobase. There are many websites that question the validity and motives of Dr. Stephen Barrett(5, 6).

Homola, another voice against nervoscope utilization, receives money from traffic to chirobase. Homola’s books are readily advertised on the site and the more traffic these posts get, the greater chance he has of padding his retirement fund(5). It is important to consider the financial gain these two stand to make as a potential bias and to not discount or discredit instrumentation based on the opinion of few where research encouraging its utilization is available.

References:

(1) Chang L, Abernathy M, O’Rourke D, Dittberner MK, Robinson C. The evaluation of posterior thoracic temperatures by telethermography, thermocouple, thermistor, and liquid crystal thermography. Thermocouple 1985;1:95-101

(2) DeBoer KF, Harmon RO, Chambers R, Swank L. Inter and Intraexaminer reliability study of paraspinal infrared temperature measurements in normal students. Research Forum 1985; Autumn:4-11

(3) Guyton, AC. Textbook of medical physiology. Sixth ed. Philadelphia: W.B. Saunders Co., 1981:710

(4) Hamilton BL. An overview of proposed mechanisms underlying thermal dysfunction. Thermocouple 1985: 1:81-7.

(5) https://www.chirobase.org. Web. 2018.

(6) https://www.quackwatch.org. Web. 2018.

(7) Mitchell GAG. Anatomy of the autonomic nervous system. London: E and S Livingstone Ltd, 1955:116-118.

(8) Plaugher, G. Textbook of Clinical Chiropractic. P93-97

(9) Plaugher G., Lopes M., Melch P., Cremata E., The Inter and Intraexaminer Reliability of a Paraspinal Skin Temperature Differential Instrument

(10) Plaugher G. Skin temperature assessment for neuromusculoskeletal abnormalities of the spinal column: a review of the literature. J. Manipulative Physiol Ther 1992;15:July/Aug

(11) Rademacher, WJ. A Premise for Instrumentation.

(12) Spector B., Fukuoka F, Kanner L., Thorschmidt E. Dynamic thermography: a reliability study. J Manipulative Physiol Ther 1981;4:5-10

(13) Wall PD, Devor M. Sensory afferent impulses originate from dorsal root ganglia as well as from the periphery in normal and injured rats. Pain 1983;17:321-339.

Note: This blog article is written by an intern that has a bright future in Chiropractic. She is eventually going to lead her practice in her community and hopefully the Gonstead Clinical Study Society as well.  Dr. Zen Matsuda D.C. G.C.S.S. Diplomate, C.C.W.P

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Chiropractic Adjustment-Side affects, Reactions, Adverse Reaction

The chiropractic adjustment is a special procedure that a Chiropractor does to correct or relieve your underlying problem called subluxation. The Chiropractor spends years mastering to correct a subluxation. Subluxation causes pressure on your nerves and causes other symptoms health conditions. Some Chiropractors adjust many segments for up to 7-10 segments. Chiropractor with more scientific and specific approach adjusts fewer segments to get the most positive outcome. As an analogy, we say that adjusting the spine is like a hammer and a bent nail. We can quickly fix the problem by smashing the nail and bend the nail even more and we can never go back to fix it again. Or a more corrective adjusting is like gentle tapping and nudging can get the nail into the correct spot without bending the nail further. Here are following Chiropractor’s approach, who will be specific and scientific:

  • In which direction is the vertebra out of alignment?Spine
  • What is the minimal amount of force necessary for re-alignment?
  • Is it better to adjust facing down or on their side?
  • Are there any factors which would prevent the adjustment?
  • Is the client relaxed enough for the adjustment?

An experienced Chiropractor has a checklist in their mind and goes through them quickly. As Chiropractors are more experienced, as they go through their mental checklist another factor plays is their intuition after many adjustments they have done in the past. An adjustment from one chiropractor may feel different when given by another. Simply due to physical differences of the Chiropractor being short or tall, different hand sizes, or any other can make a different chiropractic adjustment.

Side Affect:

After an adjustment, some people experience a feeling of deepening peace and relaxation. This relaxed feeling may last for the rest of the day or week and may lead to deep, refreshing sleep. Others have at times felt warm feeling flowing to various parts of their bodies that are very soothing. Some feel very energetic and do all their chores and business that day with light, happy feeling.

Others may find that their symptoms have begun to disappear, that the problems that they came to the office for have begun to lessen after the first visit. This is never to be confused that the problem is gone for the rest of your life. Just like working out and building muscles, healing takes time. There are also some people who do not feel any different after an adjustment. People with chronic problems usually do not see the immediate results right away. This does not necessarily mean that they are not benefiting from their adjustments, an absence of no effect after an adjustment just means that they’re not feeling any external reactions.Ask-your-doctor-if-getting-adjusted-is-right-for-you

Reactions:

Another set of people, usually a minority, may feel discomfort, muscle soreness or even some pain and they may experience a headache or some other uncomfortable feeling. There are many reasons and they are the following:

  1. You may be experiencing a detoxification: Cleansing of your body starts to initiate after the adjustment. When toxins and poisons leave the body systems, there may be the increase in discomforts such as a headache, sniffles, a slight fever, strong feeling of drowsiness, lethargy or any similar reactions. There is an increase in blood flow to get rid of the toxins from the body systems, they tend to have an external reaction that is noticeable.
  2. The muscles are starting to realigning the spine. After a Chiropractic adjustment, often the muscles that haven’t worked for many years may be in a weak state. Now that the muscles are starting to work again they may become sore or “charlie horse.” This condition is temporary and will soon disappear after muscles have strengthened themselves.
  3. The nerves that were compressed for a long time are now coming back to life. Old injuries that haven’t healed completely may be reawakened in order for more complete healing to start. It is often times old memories and feelings associated with the original injury may also come to the surface.

Adverse Reaction:

There are claims online stating that there are severe complications such chirotable290x196as stroke, neck pain, bleeding in the brain, headaches. Most of these online articles do not have much evidence and objective facts that are only for shocking people in the media. Although, if a Chiropractor was not being careful and reckless with the Chiropractic adjustments, there can be problems that can be created. There are chiropractic offices that tend to adjust the same locations or adjust as many as 10 segments or joints each visit. Some are not utilizing any examination before they adjust or after they adjust. When Chiropractors are specific and scientific, the adverse reactions are less likely to occur.

“Any person can learn to hit the high spots, replace and displace vertebrae, relieve one disease and cause another. Let us as chiropractors, show the world that chiropractic is a science….Why not be specific….Why not combine the science of chiropractic with the ART of adjusting?” – D.D. Palmer (Founder of Chiropractic Profession)

“Chiropractic is not easy. It is a scientific approach. In order to get those things right, they have to be so right. None of us can be too careful. Too many of the chiropractors are unwilling to really study enough to truly understand spinal mechanics.” –C.S. Gonstead ( Known as “Miracle Man,” Founder of Gonstead Chiropractic Technique)


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Chiropractic Quotes

“ Chiropractic should not be practiced on a probability basis. Certainty must be the ultimate aim…if not he will not have developed the investigative skills required to ferret out and find the answers to the patient’s underlying problems.”- Robert Herbst

“The right number and right kind of adjustments can set the stage for nature to heal; too many adjustments in the wrong place can undo any good that was done and slow down the healing mechanism.” – C.S. Gonstead

“ONE of the most important skills a chiropractor needs to develop is the ability to find nerve pressure –to find it exactly, specifically, where it is on each patient. If a chiropractor is not removing nerve pressure, he is not practicing chiropractic. The science and art of removing nerve pressure, and the results obtained, will stand the scrutiny of even the most resolute opponent.”-C.S. Gonstead

“A Gonstead correction of nerve pressure is more than just an adjustment . . . it is a scientific “setting” of the affected vertebra ONTO the disc below. It is of the utmost importance to be specific in the application of philosophy and especially the adjustment.”-C.S.Gonstead

“Reposition the vertebra to take pressure off of the nerve and you will get sick people well.”-C.S. Gonstead

“If there was no nerve pressure to any gland or organ, the body can produce any drug it needs.” – C.S. Gonstead

“Chiropractic without specificity is nothing.” – B.J. Palmer

“Chiropractic is not an alternative to medicine nor is it complementary to medicine. It is a separate and distinct science, art and philosophy of health and healing. Chiropractic is the largest natural healing art in the world. It has based on the premise that the body is a self-healing organism and that the nervous system is the master control system of the body. Minor displacements of the spinal bones knowns as vertebral subluxations can cause endangering stress to the spinal cord which act as the main line of intelligence for the whole body. These displacements, or subluxations, are the cause of many of the unwanted health conditions that people suffer from every day. Although there have been many valuable techniques that have been developed in the chiropractic profession, the Gonstead System is considered a “Gold Standart” for chiropractic techniques because of its record of safety and effectiveness in correcting vertebral subluxation.” Gonstead Clinical Studies Societies