But as the chiropractic profession has come of age, building upon and strengthening its educational system each year, the improvement has been reflected in the media. Positive articles on chiropractic manipulation are appearing frequently in widely-read publications such as McCall's magazine (see the July 5, 1991 issue of "DC"), and yes, even in the respected New York Times.
As an indication of how views toward manipulation and chiropractic have changed, the New York Times ran an article in its July 3, 1991 issue, "Back Manipulation Gains Respectability." The article covers, in a positive manner, the important findings of the recent RAND Corporation's research project and the benefits of manipulation. (Please see "Chiropractic Research at the RAND Corporation," "The Development of Chiropractic Standards of Care," and "Interview on June 6, 1990 -- Robert Brook, M.D." in the December 19, 1990 issue)
The author of the article explains that the RAND consensus panel included MDs, osteopaths and chiropractors, and also outlines the goal of the project: "... the group was able to agree on a number of types of patients who could benefit from manipulation and a number of patients for whom manipulation would be fruitless or even dangerous." Now that the findings of the RAND project are published, there will be more available evidence that underlines the validity of chiropractic treatment.
The article described the RAND project: "In a report being made public this week, a panel of medical experts assembled by RAND to review the medical literature concluded that manipulation was appropriate for patients with certain types of low back pain. The best candidates were patients whose pain had lasted less than three weeks, who had no signs of spinal nerve damage and whose spines appeared to be normal in x-rays. In studies, patients in this group had significant relief after manipulation and were able to return to work sooner than similar patients treated with conventional methods."
The author's sources for the article are a testament to her excellent research. She quotes two knowledgeable and very respected DCs, Dr. Scott Haldeman, steering committee chairman for the upcoming 1992 Chiropractic Quality Assurance Conference, and Dr. Louis Sportelli, past chairman of the Board of the American Chiropractic Association (ACA). Dr. Haldeman is quoted in the article as saying, "Chiropractors, who used to be ostracized, are now invited into major hospitals, HMOs and practices." Dr. Sportelli says of MDs in the article: "Until a few years ago they were still buying into the AMA effort to eliminate chiropractors. Now there's no stigma attached to referring people to us."
The author also quotes medical experts such as Dr. Paul Shekelle, a leader of the RAND project; Dr. John Frymoyer, director of the McClure Musculoskeletal Research Center at the University of Vermont; Dr. Nortin Hadler, professor of rheumatology at the University of North Carolina Medical School at Chapel Hill; Dr. Stanley Paris, a physical therapist on the Boston University faculty; Dr. Stanley Bigos, orthopedic surgeon at the University of Washington; and Dr. Vert Mooney, back specialist at the University of California at San Diego.
MDs began to take notice of chiropractic effectiveness about ten years ago, according to the article, when studies on manipulation began to appear in medical journals. One such study, which appeared in the journal Spine, found that manipulation produced significant relief in patients with back pain that had persisted two to four weeks. A single manipulation allowed patients to return to activity sooner than the average treatment. Subsequent studies, including those published in the British Medical Journal (Please see the July 4, 1990 issue) and the Western Journal of Medicine, have confirmed and expanded upon the previous study. The author of the Times article quotes Dr. Shekelle, "Now after years of trying to discredit it (chiropractic manipulation), people in this country are saying maybe there's something there."
The article in the New York Times explains this new attention that MDs now pay to manipulation: "The mainstream doctors' interest is as much a sign of their frustration in treating backs as it is a tribute to the chiropractors' success. Although a badly damaged spine can be diagnosed with magnetic resonance imaging and treated with surgery, most acute low back pain produces no detectable findings on x-rays or in traditional medical examinations. The patient just hurts." Apparently, MDs are realizing that if manipulation is the best alternative for their patients, it would be foolish to reject the technique.
The author of the article also notes that the American Association of Orthopedic Surgeons for the first time included a symposium on manipulation at its meeting this year, and almost a third of the 1,000 member audience admitted that they had referred patients for manipulation. Another triumph mentioned in the article: This year's edition of a widely-used textbook on back treatment, The Adult Spine, contains for the first time a chapter on manipulative therapy.
The fact that this article appeared in the New York Times, one of the most presigious, highly-respected newspapers in the country, indicates the great strides chiropractic has made. The people who comprise the paper's huge readership, both nationally and internationally, rely on the New York Times as an extremely reputable and indespensible source of information. The New York Times' positive assessment of the RAND Corporation project and chiropractic manipulation is a landmark in the growing acceptance of the profession.
Barbara Migliaccio
Second Assistant Editor