MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Alternative medicine suffers from what might be called ‘survey overload’: there are far too much such investigations and most of them are of deplorably poor quality producing nothing of value except some promotion for alternative medicine. Yet, every now and then, one finds a paper that is worth reading, and I am happy to say that this survey (even though it has several methodological shortcomings) belongs in this category.

This cross-sectional assessment of the views of general practitioners towards chiropractors and osteopaths was funded by the Department of Chiropractic at Macquarie University. It was designed as a quantitative descriptive study using an anonymous online survey that included closed and open-ended questions with opportunities provided for free text. The target population was Australian general practitioners. Inclusion criteria included current medical registration, membership of the Royal Australian College of General Practitioners and currently practicing as a general practitioner in Australia. The data being reported here were collected between May and December, 2014.

There were 630 respondents to the online survey during this period representing a response rate of 2.6 %. Results were not uniform for the two professions. More general practitioners believed chiropractic education was not evidence-based compared to osteopathic education (70 % and 50 % respectively), while the scope of practice was viewed as similar for both professions. A majority of general practitioners had never referred a patient to either profession (chiropractic: 60 %; osteopathy: 66 %) and indicated that they would not want to co-manage patients with either profession. Approximately two-thirds of general practitioners were not interested in learning more about their education (chiropractors: 68 %; osteopaths: 63 %).

The authors concluded that this study provides an indication of the current views of Australian general practitioners towards chiropractors and osteopaths. The findings suggest that attitudes may have become less favourable with a growing intolerance towards both professions. If confirmed, this has the potential to impact health service provision. The results from this cross-sectional study suggest that obtaining representative general practitioner views using online surveys is difficult and another approach is needed to supplement or replace the current recruitment strategy.

The authors do not speculate on the reasons why the attitudes of general practitioners towards chiropractic and osteopathy might have become more critical. Therefore I decided to offer a few possibilities here. The more negative views could be due to:

  • better education of general practitioners,
  • tightening of healthcare budgets,
  • recent ‘bad press’ and loss of reputation (for instance, the BCA’s libel action against Simon Singh),
  • the work of sceptics in informing the public about the numerous bogus claims made by osteopaths and chiropractors,
  • the plethora of overtly bogus claims which nevertheless continue to be made by these practitioners on a daily basis,
  • a more general realisation that these therapies can cause very serious harm,
  • a mixture of the above factors.

Whatever the reasons are, the finding that there now seems to be a growing scepticism (in Australia, but hopefully elsewhere as well) about the value of chiropractic and osteopathy is something that cheers me up no end.

142 Responses to Chiropractic? Osteopathy? No, thanks!

  • The conclusion stated:

    If confirmed, this has the potential to impact health service provision.

    Given the factors Edzard mentions, the impact may be in the direction opposite to the one I think they might like it to be…

  • Yes. I agree with you in much of what you say, even though I am an experienced chiropractor. There are many bad things going on in chiropractic, as there are in many other health care systems.Pointing them out is certainly correct. However, there is one thing we cannot omit as facts – the effects og gravity on postural balance. When most chiropractors release locked dusfunctional joints, natural postural reactions occur automatically. That is a fact and clearly undeniable.

    • Jens – could you provide us some good quality research that backs up your assertion that “When most chiropractors release locked dusfunctional joints, natural postural reactions occur automatically”, please?

      Otherwise, your “That is a fact and clearly undeniable.” is not valid at all, is it?

      I’d be surprised if there were even a reliable and reproducible way of diagnosing “locked joints”, let alone unlocking them.

      • Dear Sue Leraci / Edzard Ernest,

        Thank you so much for asking! I am thrilled. I will certainly provide research that backs up my assertion about “When most chiropractors release locked dysfunctional joints, natural postural reactions occur automatically”. But, for now, let us call the joint-release-treatments- of-locked-dysfunctional-joints simply for “treatments”, as I am really unable prove that chiropractors release locked dysfunctional joints; I just assume it, as jumping up and down articulations of patients, massaging them, providing psychic evaluations as a form of therapy, giving any medications, or most other therapies may probably all have similar physical effects on postural balance – of course – to a greater or lesser degree depending on the type of treatment and how it affects the articular positions created by the sensory nervous system.
        Possibly, chiropractic therapy is most efficient, as DCs are very good at mobilizing articulations? Here, investigating the various physical effects of different treatments is probably the best kind of research and the most needed research in the future, not research bringing evidence about pain reduction, as pain has both mental and physical components and pain is assumedly a simple derivative of symptomatic expressions from overloaded inflamed tissues (?), assumedly caused by poor postural loading conditions.
        Thus, I will provide you with an explanation of the research substantiating my claim about therapeutic stimulations producing natural automatic postural reactions in a few days. The reason for this wait is that I have more urgent business to attend to presently, as I am now a pensioner and I need to help my wife hang up new curtains, etc. etc. for Christmas. Thus, my real answer will have to wait a few days. Besides, I have previously presented to various chiropractic institutions as well as our so-called chiropractic research institutions how chiropractic works. On the other hand, they have never asked for any research and explanation about why and how the human body physiology acts as it does; though, they have been very polite towards me, but I am sorry to say that chiropractic college professors clearly do not grasp the importance of my findings in my research. Therefore I see blank eyes when I tell them about my research. Possibly, chiropractic institutions may not like that bones do not have to be “put specifically back in place” in order to achieve optimal results and that less pain just come from improved postural loading conditions produced by normal physiology. Assumedly, this there will be pain reduction in all erect humans when the force of gravity and normal physiology functions normally. What I have found is that a normally functioning sensory nervous system balances the posture with a perfectly horizontal upper transverse pelvic line (TICL).
        My clinical research about the normality of maintenance of the upper transverse pelvic line has been collected from 896 musculoskeletal patients during the whole year of 2008 and it shows (proves) that chiropractic therapy produces automatic, naturally good, physiological reactions in order to optimally balance the posture. This effect may possibly be induced by most other forms of therapy affecting articular tissue dysfunctions and therefore chiropractic institutions seemingly have little understanding for a physiology that normally strives to – according to homeostasis – maintain a perfectly horizontal transverse superior iliac crest line in all erect humans. Also, when patients have discus hernia and their spines have become completely crookedly twisted, it is quite amazing to observe how the horizontal perfection is still present when spines and the body itself are extremely crookedly twisted out of shape. Possibly, this evidently happens because the pelvic area has the greatest postural loads and because a perfect horizontal plane of the pelvic area provides optimal postural loading conditions.
        Said proof brings evidence showing the existence of an anatomical frame of reference for postural balance in all erect humans. It demonstrates that when assumedly locked dysfunctional joints / inflamed tissue are treated by adjustments and/or percussion hammers, natural postural reactions occur automatically, making a diverging TICL perfectly horizontal. So, when these reactions are measured with an anatomical spirit level and the pelvis is measured as a diverging transverse pelvic line before therapy and after therapy, natural reactions have produced a perfectly horizontal upper transverse pelvic line (TICL = postural frame of reference), the rest is quite clear. However, this should be seen and experienced.
        So, with the help of a manual anatomical spirit level, the horizontality of the postural frame of reference (TICL) may guide any chiropractic clinician (including osteopaths, physiotherapists, MDs) in their endeavour of treating patients with postural problems, especially those producing musculoskeletal pain syndromes caused by poor postural loading conditions. Poor postural loading conditions are assumedly the most common cause of neck and back pain and improving the postural balance could possibly be the best therapy for these people.
        While waiting for my explanation for a few days, my research (2008 Survey) may be read on Academia’s website, https://palmer.academia.edu/JensAndersKjersem
        Additionally, I will recommend my digital book, Proving Chiropractic, which may be downloaded (completely free of costs) by anyone from said website.
        Please also note that I will not provide the whole research survey (2008 Survey), as it is probably too long for this forum, but it may be downloaded and/or read on said website.
        Also, if you should happen to think that my research is not up to the perfection you wish, it must be mentioned that it is made on a very large number of patients who all sought chiropractic care from me during the year 2008. I did not include or exclude anyone and the measurements were physically made on each patient with an anatomical spirit level before and after therapy. I used the spirit level to properly measure the positions of the pelvic crests against the force of gravity, as a spirit level shows the actual physical transverse placement of the pelvic anatomy in relation said force of gravity. I know most researchers like statistics and also that I used a very uncommon method for my research of these 896 patients, but this method provided the best proofs and clinical indications for me, both as a human and as a practicing chiropractor looking for the truth.
        As far as I can see, one may criticize that my measurements were made physically and therefore subjectively (more open for making a few mistakes), but with the large number of patients in this survey and the results showing that 100 % of the patients got positive changes when measured against gravity, these facts by far outweigh any critic. Additionally, the measurements are reproducible by anyone wanting to learn measuring properly with an anatomical spirit level. Thus, others may test patients and chiropractic therapy in the same way as me. I feel that this method should be taught in clinic and at chiropractic schools – in fact, to all healthcare disciplines. A manual anatomical spirit level (PAI) costs very, very little; however, I am now also considering developing an automatic measuring device making ultra-sound measurements to avoid the manual use of the PAI and the use of the correct technique of placing the PAI into the side-flesh (love-handles) on top of the iliac crests. However, such an apparatus would cost much more than a manually operated PAI.

        Sincerely,

        Jens Anders Kjersem, DC
        jensadk@gmail.com
        +47 900 38 545

        • I will certainly provide research that backs up my assertion…

          But, for now… as I am really unable prove that chiropractors release locked dysfunctional joints; I just assume it…

          Possibly, chiropractic therapy is most efficient, as DCs are very good at mobilizing articulations?

          Thus, I will provide you with an explanation of the research substantiating my claim about therapeutic stimulations producing natural automatic postural reactions in a few days. The reason for this wait is that I have more urgent business to attend to presently, as I am now a pensioner and I need to help my wife hang up new curtains, etc. etc. for Christmas.

          No worries, I completely understand that, to chiropractors, and to all alt-med practitioners and other woomongers, helping their spouse hang new curtains is, and always has been, far more urgent than providing evidence of efficacy, and informed consent, to their clientele.

          Many thanks for your confirmation.

          Sincerely,

          Pete Attkins

          • Dear Pete Attkins,

            Thanks for your English language lessons. I believe your comments speaks for themselves.

            Whether you are staff or not on this blog, and whether your word, woomongers, are correctly spelled or not, detail-oriented as you are, you still keep ignoring physical facts showing how chiropractic physically works on postural balance after chiropractic therapy when posture (horizontal plane of upper pelvis) is measured on 896 patients with an anatomical spirit level.

            However, I gave you an offer in my last comment to this blog, but you are probably going to ignore that too?

            Sincerely,
            Jens

          • Jens,

            What was your control group and what were the results from it? This is a serious question because, without knowing this information, 100% success with 896 patients is meaningless.

            In my field of test and measurement, I would be very suspicious of my methodology if I’d designed a test that never produced a negative result. In other words, a test that always produces a positive result isn’t a test of anything at all.

            No disrespect indented,
            Pete

          • Dear Alan

            The same findings should be reproducible for you. That is why I offered what I did. 100 % is admittingly stange and that is why I believe a perfectly horizontal TICL is a postural frame of reference.

            Possibly, this horizontal perfection happens because loads are greatest on top of the horizontal plane of the pelvis. And, possibly, the PAI does not measure (show) very minute TICL divergences.

            In the beginning, these clinical measurements were not thought of as a double blind clinical trial, but a test to see if some percussion hammers (TPH) could do better when ordinary chiropractic adjustments failed (they did.). This just happened to all the 896 (except 8 persons whom.I recalled and found they had great cloaked anatomical deficiencies; so, when these were corrected with heal-lifts, all were measured perfectly horizontal).

            I also found that seemingly almost everyone will get a perfectly horizontal TICL after a while – with or without treatments – that is how the body heals naturally. Thus, I have discovered a postural frame of reference.

            This is all told in my publications.

            When I treated a person and did not get an improvement, I looked at lesser conspicious tisses and as a rule, they changed the posture when treated.

            Then, there were postural changes that did not occur. However, when using the percussion hammers (TPH and TC) against various dysfunctional tissues, postural changes occured.

            Continued:

            What I had expected to discover was just a simple improvement of the horizontality of the TICL, not that all TICLs should become perfectly horizontal (which sound absurd but is true.). But, that is exactly what happened and that may happen to everyone able yo treat a similar way (that should not be so difficult for most chiropractors). If exercises also mobilize the postural articulations in the same way, chiropractors have an honest competitor; then, they should start recommending more exercise programs than they do. However, if the aforementioned is what takes place in the body due to naturally working physiology and the force of gravity, may systems of specific directional adjusting in chiropractic needs to be rewritten. However, there is one thing you cannot take away from chiropractors and that is that their empirical based techniques are good mobilizing techniques, which will affect postural balance naturally.

            Also, no offense taken, as I got used to derogatory English humour when having contact with many members of Round Table Clubs in England in the seventies and eighties.

            And, also, please be more indulgent with my English language, as I no longer speak or write it very often.

          • Oops, the Sun was shining on the screen. I meant to write:

            No disrespect intended,
            Pete

          • Dear Alan

            The same findings should be reproducible for you. That is why I offered what I did. 100 % is admittingly stange and that is why I believe a perfectly horizontal TICL is a postural frame of reference.

            Possibly, this horizontal perfection happens because loads are greatest on top of the horizontal plane of the pelvis. And, possibly, the PAI does not measure (show) very minute TICL divergences.

            In the beginning, these clinical measurements were not thought of as a double blind clinical trial, but a test to see if some percussion hammers (TPH) could do better when ordinary chiropractic adjustments failed (they did.). This just happened to all the 896 (except 8 persons whom.I recalled and found they had great cloaked anatomical deficiencies; so, when these were corrected with heal-lifts, all were measured perfectly horizontal).
            I also found that seemingly almost everyone will get a perfectly horizontal TICL after a while – with or without treatments – that is how the body heals naturally. Thus, I have discovered a postural frame of reference.

            This is all told in my publications.

            When I treated a person and did not get an improvement, I looked at lesser conspicious tisses and as a rule, they changed the posture when treated.

            Then, there were postural changes that did not occur. However, when using some percussion hammers against various dysfunctional tissues, postural changes occured.

          • Nobody’ s going anywhere near my tisses with any hammers, percussion or otherwise.

          • If you go to YouTube and search for SMT-Therapy, you may play the demo on your phone, tablet or even cast it on your TV. It first shows a PAI being used and then it shows how to use the TPH and TC on different places on the body needing to be mobilized. However, a treatment usually takes 30 to 60 seconds with stamping thrusts (this demo only shows a few stamping thrusts in each area).

            This Specific Mechanotransduction Therapy or SMT-Therapy is not very painful and it is actually very efficient; it is so simple that even you may use these instruments right away. The chiropractic expertise is, on the other hand, the ability to find the areas in need of treatment (which produces postural changes). All the way at the end of this demo-film, there is shown how the instruments may be used for treating horses.

            If a patient with a sensory disturbance and a diverging TICL is standing erect with a PAI mounted onto the pelvis, this patient’s affected tissues may generally be treated with percussions from the TPH and you may observe by the help of the PAI how postural changes produce a perfectly horizontal TICL. Better reproducible physical proofs than that cannot be asked for!

          • @Jens

            We sill await your good evidence rather than speculation,wishful thinking and anecdotes.

          • If you are awating double blind research demonstrating how chiropractic therapy affects posture, you will have to wait till the end of time. No one will not be able to discover a postural frame of reference – perfectly horizontal TICL – affecting all erect humans that way; that is not the way to do it.

            All erect humans, except those with very great anatomical anomalis (deficiencies) will possess the sensory function carrying maximum loads while balancing and maintaining an erect posture with a perfectly horizontal plane. This can only be found with an anatomical spirit level measuring the horizontal plane of the upper pelvis. If you did not get this from my previous explanation, you may never get it. Sorry.

          • Jens,

            All erect humans, except those with very great anatomical anomalis (deficiencies) will possess the sensory function carrying maximum loads while balancing and maintaining an erect posture with a perfectly horizontal plane.

            No, they won’t. One of my legs is approximately 1 cm longer than the other, which is well within the bounds of being classed as normal by experts in medicine. It is classed as abnormal only by osteopaths and chiropractors (who have told me that I need custom-made footwear plus regular maintenance treatments).

            You are using the pseudoscientific method: Collecting evidence to confirm your beliefs.
            https://en.wikipedia.org/wiki/Pseudoscience

            You are the one who doesn’t, and probably never will, “get it”.

          • Not really. The body adapts normally from 7 to 9 millimetres to maintain horizontal TICL perfection (The adaptive measurement of 7 – 9 millimetres is relative to leg length measurements, as other bones, like the two pelvic bones, may also produce anatomical shortness on one side compared to the other). So, if you have a true “anatomical leg length deficiency” of 10 millimetres, this one millimetre should normally be picked up by any chiropractor (as it reproducible with a PAI), who uses measurements made with a PAI.

            If you have a tissue inflammation producing a sensory disturbance, your postural balance would maintain your crooked TICL divergence even if I increased your leg length on the side of your anatomical shortness by 5 millimetres. However, if I increased it more, let us say by 10 millimetres, this would be greater than the posture would normally be able to compensate for, and you would therefore become perfectly horizontal. You would not tip over to the other side either, because the body posture seemingly tries to maintain a perfectly horizontal weight-bearing plane of the upper pelvis by producing postural crookedness naturally. This is also hard to discover by using a lumb line, but much simpler to see physically with the use of a PAI.

            Commonly, when people suffer from neck and back pain, about 70 % of these patients have various degrees of TICL divergencies while stangely enough about 30 % have absolutely perfectly horizontal TICLs. These seemingly do not have any sensory receptor disturbances.

            Most of the 70 % – patents seemingly have sensory receptor disturbances in affected tissues (seemingly, as I cannot prove that, yet), but when tissues are treated with chiropractic therapy and/or percussions wth a Trigger Point Hammer (TPH), most of them assume perfect TICL horizontality instantly. This effect is physical and therefore possible to measure with a PAI. Thus, you need a PAI + a chiropractor to reproduce my findings – not a double blind test.

            Another thing: The body posture is dynamic and produce postural alterations over time. So, when patients walk around with heel-lifts, they need to be rechecked with a PAI once in a while. This is also how you may use the PAI to treat scoliosis (affecting postural crookedness). For this effect, you may use a double blind test.

          • @Jens

            No, I’ve just waiting for some good evidence for chiro.

          • @Jens

            You seem to be more interested in promoting your PAI device than in responding to the comments of others, all of which are asking you to provide evidence. Not necessarily a double blind clinical trial, just scientific proof of what you are claiming about the PAI device and the biomedical science surrounding it.

            In your many responses you convey the impression of not having a first clue about the scientific method. It’s just not enough to tell us about something. Please try really hard to understand why you’re accused of “speculation,wishful thinking and anecdotes” (Alan Henness), and “Collecting evidence to confirm your beliefs” (Pete Attkins), to quote the two most recent.

            Please also try to undertand we are not ‘staff’ of Professor Ernst, just independent people with an interest in altmed who would like to be convinced, but are repeatedly confronted by folk like yourself who don’t even understand the vary basics of EVIDENCE (and,in your own case, add to the already bad impression by not reading what people say).

          • I understand that I need a control group as evidence in order to fullfill your needs, but I say it again: Physical measurements of every patient in one year does not necessarily work with a control group. It works like diverging or not diverging TICLs, which show 100 % positive results for postural changes bringing on a perfectly horizontal TICL – even though this is unbelievable to you all. However, I have also subjectively observed that sensory dysfuntions in the neck usually bring on less diverging TICLs than sensory dysfunctions in the lower back. And, researching that kind of information will need a control group in order to manifest itself, as this does not always happens because once in a more rare while it is the opposite. However, the TICLs of 896 patients during 2008 came out perfectly horizontal – all of them. Even if you devide up the first 6 months as one trial and the next 6 months as a control trial, it will still be the same for all – perfect TICL horizontality.

            I have written honestly to you, but I am accused of “promotion, speculation, wishful thinking and anecdotes”. I have already presented enough physical evidence as it is. This evdence is very simple, may be too simple, but it is not believed because it is not backed up by a control group. However, I have offered a free anatomical spirit level for your blog-friends (see, I did not write staff) to evaluate this physical evidence for themselves. Therefore, I am not willing to discuss anything on this blog anymore. So, you may be happy to see me go – even with factual physical evidence backed by 896 patients.

            I refer to you in your own blog’s “serious” words: “Sod that for a Lark”.

          • So, when patients walk around with heel-lifts, they need to be rechecked with a PAI once in a while. This is also how you may use the PAI to treat scoliosis (affecting postural crookedness). For this effect, you may use a double blind test.

            No, the patients are expected to adapt to having a chiropractor on their back, who is also pillaging their wallet.

            The body adapts normally from 7 to 9 millimetres to maintain horizontal TICL perfection…

            No, it is not the body that adapts: it is the premotor cortex and the primary motor cortex that provides our adaptation to cope with both our structural asymmetries and our abilities to deal with off-balance loads.

            Obviously, you have never properly studied and understood: mechanical engineering and materials science; cognitive neuroscience; the scientific method; and critical thinking skills.

            I strongly detest the insidious creep of quackery.

          • Barrie,

            My Pink Unicorn Therapy has replaced the evidence-lacking chiropractic “clicky stick” with the thoroughly evidence-based industrial-strength reamer.

            Never pooh-pooh a reamer, it can do so very much more than just open your eyes, ears, and mind.

          • Dear Pete and medical co-bloggers,

            Clearly, the physical proofs provided to you cannot be understood by you and your co-bloggers because you are totally ignorant to the fact that posture is not just static, but also dynamic. So, leg length measurements are not what they used to be – static. The posture will not just compensate for loading conditions over a long time, also be dynamic to immediate changes in postural loads. Thus, it must be clear that chiropractors make instant postural compensations producing fewer loads and less pain. These postural changes may instantly be observed with an anatomical spirit level measuring physical changes in posture (pelvic positions) against the force of gravity. The only paper written about this new physiological fact is probably mine on https://palmer.academia.edu/JensAndersKjersem

            Therefore, you owe all chiropractors apologies for derision; however, not to those chiropractors who are unethical and have inconsistent views with reality, but to most chiropractors who treat posture and musculoskeletal pain ethically, and who according to reality try to mobilize dysfunctional locked structures in order for the body to produce improved posture with less pain.

            The most efficient way of proving what I say – is to make physically observable and reproducible proofs:

            Let us say that you have a completely healthy erect person, who does not have anatomical leg length deficiency, who does not have tissue disturbances affecting sensory receptor functions, and who does not have any sickness or physical problems. This person ought to have a perfectly horizontal TICL. If you mount an anatomical spirit level in a proper way onto this person’s upper iliac crests from behind, you may observe the horizontal perfection of the TICL in the meter (water bubble) of the spirit level. Then, you may increase the leg length of this person with 5 mm on one side only, and you will see by the help of the anatomical spirit level that the horizontal perfection of the TICL will stay put. Then, you may make the same increase of the leg length on the other side of the body and you will also be able to observe the same. What this tells you is that the body posture via the sensory nervous system physically reacts to small postural changes in order to maintain an ideal perfectly horizontal weight-bearing plane of the upper pelvis. In order to do that, postural balance needs to produce minute postural weight-bearing changes of all postural articulations, not just in the pelvic bones. Of course, you will probably all resist these conclusions and carry on with your derogatory British waggish wittiness.

            Through clinical testing (not proof), I have come to observe that the body is able to naturally cope with “leg length changes” (including other dual bone asymmetries) of about 7-8 mm or 7 – 9 mm of deficiency. Though rarely, I have come across persons who could not compensate for more than 2 mm on each side of the body while on the other hand I have also rarely come across persons who could compensate for up to 20 mm. Conversely, I have never yet come across any erect person – even among the 896 patients in my clinical survey and all patients treated after 2008 (also those treated with the “clicky stick”) – that finally did not end up with horizontal perfection of the TICL.

            Thus, I have discovered that a perfectly horizontal TICL may be used as an anatomical frame of reference, which may be measured against gravity with an anatomical spirit level.

            Personally, I used a Pelvic Angle Indicator (PAI) in my former practice, but you may all make your own anatomical spirit levels, as they are really simple to make (I say this to you so you may understand that I do not promote sales); however, from a steel factory, one generally has to order a certain number of anatomical spirit levels and additionally, a rig has to be made so that the spirit levels can be welded together properly. It is, of course, of outmost importance that said anatomical spirit levels can position themselves in perfectly horizontality so they can properly measure and physically demonstrate the exact physical horizontal position of the upper pelvic plane.

            Presenting these new physiological findings is herewith my final answer to this blog and I wish you all a Merry (and witty) Christmas. It is also Jesus’ and my wife’s birthday today, and I must say that her curtains hang beautifully by the help of a chiropractor, too.

            Sincerely,

            Jens Anders Kjersem, DC

            +47 900 38 545

            https://palmer.academia.edu/JensAndersKjersem

            jensadk@gmail.com

            https://www.youtube.com/watch?v=7ay_GUPFzN0&t=1s

          • Jens Anders Dag Kjersem-
            You are of course utterly incorrect about the date of the fellow Jesus’ birth.
            But- people often tend to believe nonsense once they’ve set their mind to it.

          • You are of course correct as always, but in Norway the greatest celebration is tonight with both pork ribs and lam ribs. However, enjoy your celebration tomorrow morning. I mean that.

          • Jens,

            Merry Christmas. I’m sorry; you’re a loony. A very kind and well-meaning one, but a loony just the same.

            Maybe Edzard will block this comment since that remark is 100% ad hominem. But your posts leave no room for any other interpretation: you’re right up there with other folk who have similarly designed medical machines based round a theory they have evolved in their own heads. You link to your webpage for supportive evidence, and you seem to have written several papers. But why haven’t you published your work in any peer-reviewed journal? That’s the way professional scientists communicate their findings.

            Your link to the YouTube video is, for me, the final straw. I have ceased to find it funny to watch chiros using their clickety sticks on patients, particularly on peoples’ necks. If you imagine this is in any way a demonstration of medical skills, you’re dead wrong. Please try one of Wilhelm Reich’s orgone accumulators; Reich, in a manner similar to you with your PIA and your clickety stick, managed to convince himself his orgone theory was right and his machine was important, despite perfectly reasonable criticisms from people who knew better.

          • Comments to Frank Odds and his co-bloggers,

            Yes, I am a loony, but mainly in yours and your co-blogger’s eyes; that I do not doubt that for a second. Additionally, you are all probably good at calling nicknames to a person at a hundred yards distance so you don’t get smacked. The use of “ad hominem” attacks of character and the way your co-bloggers controvert the use of English language factually express that this blog is not a very serious science forum. Possibly Edzard Ernst should have blocked you all, but then, on the other hand, he would not have any blog to amuse himself with. However, I do make mistakes, as I mistakenly stigmatized all members of Round Table Clubs. I am sorry for that. I should have mentioned that my negative experience concerned a very few specific members of Round Table Clubs, who in general is affiliated as a wonderful and good organization. On the other hand, the bloggers I have met in this forum are trying upholding to be great interpreters of quality scientific evidence, even mechanical engineering and cognitive neuroscience. The use of their critical thinking skills about their scientific methodology is however not very good at all, and neither is their use of derogative humour. However, I am personally quite sure they are capable of answering arguments with facts – if they care to, as the last “funny” member of Round Table staying in my home got drunk and wiggled his face in a fruit basket, tearing the soft juicy fruit apart. In real life, he was actually a smart man.

            To remind you, here is what you said (quote):
            “In your many responses you convey the impression of not having a first clue about the scientific method. It’s just not enough to tell us about something. Please try really hard to understand why you’re accused of “speculation, wishful thinking and anecdotes” (Alan Henness), and “Collecting evidence to confirm your beliefs” (Pete Attkins), to quote the two most recent.”
            Pete Attkins: “What was your control group and what were the results from it? This is a serious question because, without knowing this information, 100% success with 896 patients is meaningless. In my field of test and measurement, I would be very suspicious of my methodology if I’d designed a test that never produced a negative result. In other words, a test that always produces a positive result isn’t a test of anything at all.”

            The science of testing cannot always be used according to Cochrane system, as physical facts are not evidence-based facts – they are incontestable facts because they are physical facts. Additionally, they will always be incontestable because they are reproducible facts. In other words, each measurement with an anatomical spirit level is physically related to the force of gravity as a frame of reference. One does not need a control group for measurements related to the force of gravity. Also, when physically measuring the TICL, all patients had to hold onto the solid steel arms of the anatomical spirit level, pushing it downward and forward into their own side-flesh (love-handles) while holding it horizontally. In other words, patients held onto the spirit level after it had been placed properly on top of each pelvic crest. The final positioning was actually done by each patient, who could observe the result, as the meter of the spirit level was at the rear. Thus, each measurement was finally done by the patient and without any fault – a millimetre divergence is simple to spot with this anatomical spirit level. But, with 896 patients, a few faults would not count very much anyhow. Concerning this testing, Pete Attkins says that 100 % success is meaningless for evidence-based testing. Of course, I certainly agree with that, but this is not evidence-based testing; it is physical testing controlled by the force of gravity.

            Patients did not seek my therapy for the success of getting an improved and optimally balanced posture with horizontal perfection of the TICL. They simply sought me to get rid of their musculoskeletal neck and/or back pain. And, improved postural balance does not get rid of pain instantly – certainly not completely right away, as an improved postural balance only reduces loads and then pain. Therefore, one can only assume (believe) that my therapy made them feel better – more or less. How long they kept the improvement of postural balance, I did not know – some of them maybe just down the street. However, I certainly helped them with their pain – then and there – instantly. But, testing the ease of pain is different from testing physical facts. So to be clear, pain cannot be measured physically, but postural balance – on the other hand – may be measured against the force of gravity as a frame of reference, if a postural frame of reference relative to the force of gravity exists; that is totally different.
            *
            Most patients require several treatments to reduce and/or finally get rid of most of their pain; my patients were no different than others. A few patients discontinued their treatments after the first therapy session and these were interviewed on the phone. Some of them had felt instantly better and wanted to continue on their own while a few others said they felt instantly completely well. No one told me that they got worse and discontinued therapy because of that. (Usually, patients discontinue chiropractic treatments due to their economic situation.) Some patients with excruciating pain were labelled as hernia patients (usually later confirmed by MRI). Those in the hernia category would generally have extremely twisted postures with diverging TICLs and stretching them out properly on a side posture bench with a traction move (adjustment) would generally instantly relieve them of much pain. However, the most remarkable view in the clinic was to observe that very crooked patients with diverging TICLs came into the clinic and although they still had crookedly shaped postures, they could leave the clinic with perfectly horizontal TICLs and less pain. Even without the use of a spirit level, one was able to observe that the TICL became more horizontal within their crookedly twisted postures. When checking the pelvis of hernia patients with a spirit level one could observe that all with their crookedly twisted postures factually had naturally assumed perfect TICL horizontality after therapy. One must be quite clear about this: Chiropractic adjustments were not necessarily made in the pelvis, but still the upper pelvis naturally assumed perfect TICL horizontality. The only hypothesis I have to offer for this reaction is that when sensory receptors are triggered in the correct dysfunctional tissues, the posture will assume perfect TICL horizontality by small corrections throughout the postural articulations in order to reduce weight-bearing loads, particularly in the upper horizontal pelvic plane where loads are greatest. It is therefore both amazing as well as very strange to look at a person, who has a crookedly twisted posture, compensate for the destruction of a herniated disc while the TICL stays perfectly horizontal.

            Nevertheless, most patients returned to my clinic – generally after 2 days, unless they had extremely excruciating pain; then I asked them to come in every day in order to continually maintain optimal postural balance. However, on the patients’ second visit, I discovered that about 50 % of them (with diverging TICLs who had assumed a perfect TICL horizontality) in general maintained their new TICL-positions in a perfect horizontality. Ordinarily, it took about 2 to 4 treatments until most patients with diverging TICLs assumed a stable perfectly horizontal TICL. My impression (subjective value) of the patients was that they in general felt less pain as the horizontal TICL perfection stayed put and those patients, who seemingly (subjective value) most quickly got a stable perfectly horizontal TICL after 1 – 4 treatments, were also those who responded best with reduced pain; they seemingly also became soonest painless after therapy.
            *
            70 % of the 896 patients had a diverging TICL and around 90 % of them got a perfectly horizontal TICL fairly quickly after few treatments with ordinary chiropractic therapy. However, for the remaining (about 10 % of the 70 % – group), were treated with a TPH (clicky stick) as therapy. I assumed that these patients would respond to my special mobilizing arm movements (pushes), which also included a high velocity percussive thrust of the trigger mechanism of the TPH. This group of patients (10 % group) were resistant to postural changes and by the use of the TPH, simple adjustments could be performed against several tissue areas, also inconspicuous tissues, as treatment of tissue triggering postural change and perfect TICL horizontality were not always simple to find. However, by using the TPH against many areas, I could mobilize affected tissues/bones. I would stimulate several tissue areas and check and recheck with the spirit level to see whether or not the posture had changed. That was a very good advantage of using the TPH or “clicky stick” and the PAI together. To be clear: When a TPH (Trigger Point Hammer or “clicky stick”) is used against tissues (bones/articulations), the blow to healthy tissues would be similar to a firm clap on the shoulder, which regains normality soon. However, when treating affected tissues, the TPH will trigger latent (dormant/inactive/dysfunctional) sensory receptors and activate these. After using these instruments for many years, I can state this as an empirically based fact. Only too much therapy against affected tissue will produce trauma and such trauma lasts – at the most – for no more than two or three days. It is a very safe therapeutic instrument.

            As the loony that I am – even against perfect scientists who hold onto a belief-system of disapproving “clicky sticks” without even knowing them well enough – I have assumed that the mobilizing arm movement holding the TPH to make percussive thrust would transfer energy into specifically selected tissue (SMT-Therapy or Specific Mechanotransduction Therapy), heating them and mobilizing them to make dysfunctional sensory receptors start responding, producing an improved postural balance with a perfectly horizontal TICL. Possibly, that is too far-fetched for this belief-system, but it is (hypothetically) perhaps the best explanation for what takes place when using the TPH (clicky stick). Except for 8 persons, all TICLs of 896 patients, even the last 10 %, became perfectly horizontal. Concerning the 8 patients whose posture I could not change immediately, I recalled these 8 persons later and found that they had great anatomical deficiencies maintaining their TICL divergences. These anomalies had been cloaked by difficult postural compensations so I did not find them right away. However, when I finally corrected their anatomical deficiencies with proper heel-lifts, they all assumed perfect TICL horizontality and stayed that way, too. I had used heel-lifts on other patients, but these were more cloaked.

            Furthermore, I also noticed that patients with diverging TICLs, who were not treated, would gradually over time become perfectly horizontal naturally, unless they possessed sensory dysfunctions and/or rather large anatomical deficiencies. This is also consistent with natural healing processes, which reduces swelling and tissue compression, making sensory receptors regain normal function so that the sensory nervous system may rebalance posture optimally with perfect TICL horizontality. Note that I write – optimal postural balance with a perfectly horizontal TICL, as any posture may become even better balanced and even straighter, as posture constantly seeks optimal loading conditions for postural articulations, including less pain. Hypothetically, this is how the body over time produces less overloads, less inflammatory reactions and less pain. People simply need to use their bodies accordingly. Thus, getting rid of sensory dysfunctions and producing perfect TICL horizontality is only half way to the goal, but it is a good start. Perfect TICL horizontality in all erect humans is simply an optimally balanced posture – not a perfectly balanced and symmetrical posture with the best loading conditions possible. Person with such postures hardly exists.

            According to the above-mentioned, I should therefore have the right to assume that a perfectly horizontal TICL is a normal and natural condition for all erect humans – a postural frame of reference.
            *
            When discussing normal anatomy and physiology, it is useless to think that 100 % improvements of TICL divergences becoming perfectly horizontal is a 100 % success. Treatments tested with control groups generally concerns immeasurable conditions, and not conditions measureable against a physical frame of reference like the force of gravity. That is just as meaningless as saying one cannot get 100 % correct results when measuring the normality of the blood CRP-level, which is already has a tested procedure. The force of gravity is certainly persistent physical fact, possibly better than a thoroughly tested blood CRP procedure.

            Reducing neck and back pain concerns insubstantial parts of our physiology, as it concerns both mental and physical dimensions. Of course, evidence-based facts about treatments of pain need to be evaluated with tested procedures – a control group. The success I had when treating musculoskeletal neck and back pain patients should therefore have a control group and chiropractic has tried to produce them more or less successfully. However, I have never tested the effects of chiropractic therapy on pain syndromes, as for me it has been most important to have patients feel pain relief. However, I went outside “the box” and found simple physical facts, which I observed with an anatomical spirit level. And, I told you about my findings, which may be found on https://palmer.academia.edu/JensAndersKjersem (Whether you want to believe my findings or not is up to you, but now they are there for you to test them – if you want to.)

            The Academia website contains my papers demonstrating that chiropractic therapy produces improved posture in patients and I do not believe that they say very much about pain. With an anatomical spirit level, I can now prove some of what chiropractors do. You may deny it and disown it, but it is still a proven fact, and as improved posture reduces poor postural loading conditions, it logically reduces pain. However, If patients are going to get rid of pain, there are many other aspects to consider, like which type of conditions cause pain, how long to wait for the body to naturally reduce overloads through postural compensations, reducing swelling compressing local nerves and pain, and not least, whether or not degenerations, trauma, etc. cause some or all of the pain, for which surgery may help reducing tissue/nerve compression and thereby reduce pain.
            *
            About 30 % of the 896 patients in the 2008 Survey already had a perfectly horizontal TICL; however, they still had neck and pack pain, for which they sought chiropractic therapy. From what has been learned from the fact that 70 % of 896 patients with a diverging TICL achieved improved postural balance, it was only fair to assume that postural balance of those with already perfect TICL horizontality also would continue improving their postural balance further when treated with chiropractic therapy. Thus, chiropractic therapy should reduce poor loading conditions and pain further in all of the patients whether they had optimally balanced posture or a posture with diverging TICLs. This is based on the findings showing that patients with diverging TICL horizontality assume horizontal TICL perfection. This is not a bad hypothesis, but although it is only a hypothesis, we all know from normal physiology that posture seeks to maintain optimal postural balance against the force of gravity, and when postural balance is tampered with or altered (assumedly mobilized), natural physiological functions seek to neutralize the imbalance of tampering/alterations by balancing posture further or once again against gravity – in a natural way.
            *
            During my many years in practice, there have been many types of “clicky sticks” in chiropractic therapy and they have had varying functions and treatment systems. The TPH or Trigger Point Hammer is just one of them. It is easy to put any of them in the wrong category by just calling them “clicky sticks”. I have tested the most well-known “clicky stick” in use today; it is called Activator. Although I had a hard time producing measureable postural changes and perfect TICL horizontality with the Activator, I consider that I may have used it incorrectly. Although I did not find the Activator efficient in producing improved postural balance (making divergent TICL perfectly horizontal), there is a chance that it still may correct nervous functions somehow. However, the “clicky stick” you referred to, called Trigger Point Hammer or TPH, will – on the other hand – produce quite obvious, improved postural changes.
            *
            I have also constructed another clinical instrument that I have not told you about. That is an LLR or Leg Length Regulator, which make it much simpler and more secure to measure various anatomical deficiencies in patients. The posture is not static and will instantly compensate for increased leg lengths up to about 7 – 9 millimetres in order to maintain perfect TICL horizontality; this is new physiology may be tested and observed instantly with the help of an anatomical spirit level. When great anatomical anomalies are present in persons, these persons should have their anomalies properly corrected as much as possible. Therefore, these rather large anatomical deficiencies posture needs to be measured. The way to do that correctly while the posture instantly adapts to postural changes is to measure a lengthened leg against the anatomical frame of reference on one side first and then do the same measurement on the other side afterwards. If there are great anatomical deficiencies, one leg (deficiency) is generally more compensated for than the other. Thus, subtracting the measurement of the height increase of one leg length from the other height increase measurement will calculate how high a heel-lift ought to be. The greatest measurements will always need heel-lift corrections. Of course, this is a very particular science, which needs to be explained and demonstrated and my LLR will only provide som height notches of two and a half millimeters at the time. So, if you want to increase the length of a leg with 15 millimetres, the LLR demands to be raised 6 notches on the side in question. When a heel-lift is properly administered, the measurements relative to gravity should be equal on both sides.
            Of course, this is also important for medical science and by behaving like perfect scientists who knows everything; then, you will probably continue to measure posture and leg lengths statically.

            As your bloggers used an English expression, “Sod that for a Lark”, I will instead use a Norwegian expression covering all the aforementioned information: «Ta den igjen og mal ’an grønn».

        • @Jens

          So, to sum up, what you tell us must be true because you tell us so, right?

          • What I tell you is true because it is reproducible by others …

          • Jens Anders Kjersem said:

            What I tell you is true because it is reproducible by others …

            Is, has been, will be or might be sometime in the future reproducible by others? The difference is important.

          • Frank Odds ” @ Jens so to sum up, what you tell us must be true because you tell us so,right?”

            So what you tell us is right too, Frank?

            Has anyone noticed that this is a mere blog with contributing commenters so that accusation can be addressed to anyone of us? There are contrasting views regarding alt med on this blog, and sceptics corner the market in derisory comments. As its Christmas I am being polite : oh I forgot my default position is politeness. Why is it such anathema for sceptics to post polite comments to those of differing opinions?

            Is it necessary to call a gentleman from a different country a loon or loony (language common to your namesake on this blog)because you disagree with his posts? I can only assume you only do so because you are addressing a stranger and similarly assume you conduct yourself politely with family and friends in discourse.

            I couldn’t find a reply button for @Jens so am including my comment on his posts here :

            I am not an academic or a medical professional and don’t really understand the finer detail but nevertheless I resonated with what you said Jens. My chiropractor discusses with me posture and exercise and can even detect upon examining my body when I have missed my yoga and stretching sessions. I have a rotational problem with my pelvis and I know this because the evidence is there : before treatment one leg is longer than the other. This is rectified after treatment and I observe my legs are equal length. The consequence of adjusting the pelvis is huge for me : I no longer suffer with sacroiliac pain. Incidentally, for the critics: my chiropractor does sometimes refer to GP, suggest an X-ray and does not discuss vaccinations. Oh and never asks me to return – that is my choice.

            The critics of Chiropractic like to proffer their ‘regression to the mean’ reason for improvement. For me this is nonsense: sometimes, because my chiropractor is very busy, one has to wait a while for an appointment. During this waiting period, I suffer low back pain, neck pain and headaches. After treatment these ailments disappear, having had the atlas bone in my neck and pelvis adjusted. I also feel taller, expanded, lighter, freer – difficult to describe, but can be similar sensations to how I feel after yoga, or,indeed, Reiki. Of course only chirooractic adjustment resolves the pain, but there is undoubtedly a feeling of expansion and lightness : I am no expert but maybe this is due to the nervous system?

            Chiropractic has been a big part of my life for nearly 50 years. In my twenties I was experiencing bowel problems – X-rays and medical intervention failed to give me a diagnosis. A friend’s brother was training to be a Chiroopractor, and she thought I may benefit from a visit. At my appointment he had a well known teaching professor with him; they insisted I walked in front of them. They immediately diagnosed a problem with my pelvis and the internal problems abated after adjustment. Oh and I didn’t need to return, wasn’t asked to and no money changed hands. Of course, I had a younger body with quick recovery, but impressive, nevertheless. As one ages, of,course, I need to see my chiropractor for all the aches and pains that result from wear and tear and floor play with very young grandchildren.

            So I am thankful I have my Chiroopractor: the criticism bears no resemblance to my experiences, and thanks to our Norwegian friend (Norwegians are pleasant and polite people, by the way) for his posts it all makes a little more sense. Wishing all on this blog a peaceful and respectful new year.

          • @A

            “So what you tell us is right too, Frank?” Of course it’s not when I’m describing a hypothesis backed up with a lot of words and no (meaningful) experimental data. But it is almost certainly true when I’m merely responding to a person doing precisely that same thing.

            Jens is persistently describing a situation and a device for which we have only his word. His refusal to acknowledge or respond to the comments of others who have spelt out why he’s wrong tell us a lot about his attitude.

        • tl;dnr version: “I’m far too busy to provide any evidence but here’s a very long rambling piece of worthless nonsense instead.”

          • I am in general a Norwegian-speaking person and the English language is second to me; so, the word “moo-mongers” used by Pete Attkins was not in my vocabulary. Therefore I had to look it up and the best definition of “moo-mongers” I could find is an Australian English definition saying that a “moo-monger” is “a person with a Child-like mind”, in other words “ it was a belittling comment”.

            Then, right away, it seemed that the Edzard-Ernest-blog actually was an “unserious institution” using foul language and did not really bring facts into the daylight. However, after reading Alan Henness comments I now certainly understand why the word “moo-mongers” was used.

            Still, Alan Henness, you have to wait a few days because as pensioner I also have other tasks to do than helping my spouse hanging up new curtains for Christmas. Of course, when I was a practicing Chiropractor, it was different.

            I am not going to post the whole “2008 Survey” in as explanation in this blog, so if you cannot wait for the “short version”, go to Academia’s website and download my digital book “Proving Chiropractic” from https://palmer.academia.edu/JensAndersKjersem (it is free).

            However, from what you wrote on the reply-blog, it is doubtful whether you can read or not.

          • AND ALL THIS FROM SOMEONE WHO CANNOT EVEN COPY MY NAME CORRECTLY!

          • Nor can he copy ‘woomonger’ accurately. But at least he got your first name right. To quote a recent comment back at Jens: “from what you wrote on the reply-blog, it is doubtful whether you can read or not.”

            Jens, ‘woo-monger’ (when spelt correctly) shows up readily with a Google search. It means ‘A proponent of pseudoscientific ideas or practices.’ It derives from the mysterious forces — “woo-woo-woo” (you have to say it out loud in a dramatic voice while waving your arms about) — which seem to underpin many forms of pseudoscientific nonsense. That includes complementary and alternative medicine by the way.

            You present the link to your website disingenuously. The book may be free, but to download it I’m expected to share with you my email address, my contact list and the names of my Facebook friends. We have an English expression to cope with this situation. I hope you can understand it: “Sod that for a lark”.

            From the many items displayed on your website and your comments on this blog page it is clear you are, yourself, a master of arm-waving conclusions. Your concepts of ‘research’ and ‘evidence’ seem to be so wide of the mark it’s a minor miracle you are able to post at such length.

          • Jens Anders Dag Kjersem said:

            However, from what you wrote on the reply-blog, it is doubtful whether you can read or not.

            That is the wrong question to ask yourself. First, ask yourself why anyone with a modicum of critical thinking faculties should bother to read your book rather than good quality scientific evidence.

          • Dear Edzard Ernst, including the blog-staff (Sue, Pete, Alan and Frank),

            I am sorry that I got your name, Ernst, wrong and called you Ernest, which means honest/serious.
            Academia.edu is an official organization, but I believe that the contents of my free book may be read online, too; and, as far as I know, without providing any e-mail address, contact list and names of your Facebook friends. Though, I may be wrong, as I really do not know; I have access to editing of my own text on https://palmer.academia.edu/JensAndersKjersem . But, you certainly are correct in hiding all your contacts, because when you believe you have perfect critical thinking faculties, you may have hurt someone badly with your comments. Though, you do not have to worry about me. I understand the derogatory comments as normal British humour. Additionally, I really do not care, as I am now 71 years of age and I am no longer practicing chiropractic, nor into chiropractic politics either.

            I have received all your condescending and arrogant comments from your staff and yourself. These were: “moomongers and woo-woo-woo” – “So, to sum up, what you tell us must be true because you tell us, right?” – “Is, has been, will be, or might be sometime in the future reproducible by others? The difference is important.” – “I’m far too busy to provide any evidence but here’s a very long rambling piece of worthless nonsense instead.” – “That is the wrong question to ask yourself. First ask yourself why anyone with a modicum of critical thinking faculties should bother to read your book rather than good quality scientific evidence.” – “a very long piece of worthless rambling nonsense …” However, you also used your “modicum of critical thinking” to make a psychological evaluation of me (oh, that is real science!): “a person presenting the website disingenuously” and “a master of arm-waving conclusions who makes a minor miracle by posting at such lengths” – “Sod that for a lark.” These are all from your blog-friends who indicate they possess “a modicum of critical thinking faculties”? They are not very serious, are they? However, I believe these comments stand for themselves.

            For now, I put aside all differences and I provide you with a much shorter version than I had thought of giving you before (but less to understand):

            An anatomical spirit level (e.g. Pelvic Angle Indicator or PAI) is a very special and precisely constructed clinical instrument produced on a specially made rig making it into a correct spirit level, which may measure anatomical pelvic positions against gravity. It is an anatomical spirit level and it may measure the TICL (the Superior Transverse Iliac Crest Line) on top of the upper pelvis with great precision against the force of gravity. In other words, it operates like a normal spirit level would do and much better than a plumb-line. The PAI is the only instrument, which may demonstrate with real accuracy that postural changes relative to the force of gravity incontestably occur after chiropractic therapy. In other words, it is not enough to put your hands onto the iliac crest and measure the pelvis subjectively.

            So, why will postural balance change? That is still an unanswered question, but I assume that chiropractic therapy stimulates dysfunctional sensory receptors in swollen tissues and activates them, making them produce postural changes naturally against gravity like normal physiology does.

            I have examined 896 patients clinically in my own practice in 2008 and I believed (assumed) that I produced mobility in dysfunctional tissues by my therapy. In any case, whether I did or not is less important, because I certainly produced natural postural changes that occurred in all the 896 patients after therapy.

            On the other hand, I have not examined whether or not exercise programs, manual therapy, physiotherapy, and other therapies do the same. However, they probably do the same. I believe that it is activation of sensory receptors which make the therapies work, as chiropractic therapy certainly improves postural balance after therapy and reduces poor postural loading conditions. And, instantly improved loading conditions will also make neck and back pain patients feel better – straightaway – like chiropractic therapy seemingly does for most patients. And, some therapists will be more efficient at this while others will be somewhat less efficient. Suddenly everything fits!

            *

            As there is not any other clinical instrument on the market today than the PAI to clinically measure the posture in this way, I therefore have a suggestion for you:

            As all properly educated DCs have learned to measure the position of the iliac bones, you may contact any local chiropractor and ask if he/she agrees to examine patients with a PAI. If so, he/she may contact me on jensadk@gmail.com and I shall send a PAI for free to his/her clinic. I shall also include a user’s manual for the PAI. However, about 70 % of all neck and back pain patients have a diverging TICL, so with little instruction, most chiropractors should be able to use a PAI for measuring the horizontality of a diverging TICL before therapy and observe that the TICL becomes perfectly horizontal after therapy. When one comes to think of it: Isn’t it strange that as many as 30 % of the patients can be measured with a perfect TICL horizontality? And, that those with a diverging TICL instantly may assume perfect TICL horizontality after therapy? That is something to use your “modicum of critical thinking faculties” on! Or, in your own words, “Sod that for a lark.”

            Then you may ask what you will learn from this? Well, first of all, it may stop your mocking of chiropractors, as their treatments factually produce postural changes naturally against gravity. And, these are good changes, as they take place due to exact normal neurological balancing functions of the sensory nervous system.

            Then again, you may ask these questions: Is this how chiropractic really works? Is this how exercises works? Is this how manual therapy, physiotherapy, acupuncture, etc. works? However, you will need a PAI to observe the changes of postural balance as physical facts – and you will also need a PAI to do research on the other therapies.

          • you keep making mistakes in your opening lines, thus discouraging me to read on: there is no ‘staff’ on this blog.

          • Jens Anders Kjersem / Jens Anders Dag Kjersem / whatever your name actually is,

            As was previously pointed out to you, in detail, by Frank Odds, I did NOT write “moomongers”.

            Why are you, yet again, accusing me of writing “moomongers”. Note: The lack of a question mark [?] at the end of that sentence isn’t a grammatical error; it means that my question is purely rhetorical.

            rhetorical (of a question): asked in order to produce an effect or to make a statement rather than to elicit information.

            Accusing me TWICE for your inability to copy and paste the word “woomongers” doesn’t surprise me in the least: this is typical of the dreadful level of attention to detail, and the abject refusal to accept culpability, that is so frequently demonstrated by alternative-to-medicine practitioners.

            I do not hyphenate “woomonger(s)” for the same reason that I do not hyphenate “fishmonger(s)”, “cheesemonger(s)”, and “warmonger(s)”. When a compound noun becomes part of everyday English language, the original space becomes a hyphen, then the hyphen is eventually dropped. E.g., “fish monger” became “fish-monger” then “fishmonger”.

            Your subsequent comments have demonstrated that classifying you as a woomonger would be an insult to most woomongers.

            NB [take special note]: I never said that you are woomonger, and I never said that you are a moomonger.

            Also take special note: I particularly dislike being referred to as “staff” and implications that I am a member of staff (an employee) of any organisation.

          • Jens Anders Dag Kjersem said:

            Dear Edzard Ernst, including the blog-staff (Sue, Pete, Alan and Frank),

            Staff?! What staff do you think it takes to run a blog and how many do you think Prof Ernst has?

        • @Jens

          Note that Petiful and Odd Frank have been predictably insulting toward you despite your obvious earnestness in communicating your thoughts. These drones of Edzard consistently denigrate even the most sincere paramedical posters and wistfully joke amongst one another in some type of obscene circle jerk of jocularity. Since you are 71 y.o., I’m certain that you have learned to repel such bullying words.

          It’s amusing to note that these same two dullards disappear from conversations which demonstrate quack science in “modern medicine” such as the Paxil/GSK and the thalidomide scams, as well as the scientifically non-countenanced practice of off-label prescribing. Certainly such medical quackery dwarfs whatever non-evidence-based exist in chiropractic relative to safety outcomes. It seems that the practice of anything in chiropractic not fully supported by a 2-thumbs-up Cochrane systematic review is, according to these drainers, evidence that chiropractic is quackery; yet the same sub-scientific practice within medicine is OK. ROTF LMAO!

          It’s unfortunate that Petiful and Odd Frank failed to treat you with courtesy. I wonder if they teach their children to denigrate people with whom they disagree?

          Be well

          • Thanks for your support.

            As English is a second language to me, I cannot cleverly use words like drones and dullards, to which their behaviour are comparable to. Although I am trying to quit this blog, I will again post another last answer to Frank Odds and co-bloggers tomorrow, as I am glad to provide them with irrefutable facts about chiropractic – in spite of their facination with Cochrane, control tests and their hatred for chiropractic. This is a “war” they never can win, as they cannot in the long run deny absolute physical facts. So, I am quite certain that my info gradually will sink in, unless they are totally ……… imbeciles?

            Knowing English people from Round Table Clubs many years ago, I am quite certain that they too teach their children to denigrate people with whom they disagree. Like fathers like sons – apples do not fall far from the tree.

            Sincerely,
            JensAnders Kjersem, DC
            jensadk@gmail.com
            +47 900 38 545

          • Jens- however much your arguments may appear to some to exhibit a certain convicingness, it is but superficial.
            However many British people you may have encountered at your Round Tables, and however feverishly you think they may have tried to inculcate some of their views into their children, you then choose to omit the next stage of evidence, which relates to whether or not they succeed in doing so.
            This is a familiar trick tried incessantly by homeopaths and altmeds in general.
            To put it another way no matter how purple-faced my own father became in his attempts to argue that Fascism would be good for Britain, or that businessmen such as he should be left to run the World, and everyone else should shut up, either this particular apple did indeed fall quite a long way from the tree, or perhaps the tree stood atop a hill and I rolled quite some distance away.
            By all means, propose a hypothesis, and then look for evidence or conduct experiments to support it. . But have the courage sometimes to admit when you are wrong.
            ‘The apple doesn’t fall far from the tree’ is a delightfully concise phrase when it appears to fit, but does also work sometimes only in retrospect. History provides many examples of apples eaywardness.
            Finally, lest I forget, may I reciprocate your Xmas greetings with similar to you for the New Year. And to all others, including perhaps even the least deserving.

          • @Jens – unfortunately the absence of ‘reply’ buttons is I think creating a little mismatch but I am doing my best to keep ‘in the lines’

            Jens I am so sorry that your view of English people is not high – understandable with your exoeriences and confirmation by some posters on this blog.

            Really, some of us are reasonable and non-judgemental. I have been involved in education for many years in the UK as have my children, and we have a lot to be proud of in our young people. This blog is a snapshot and has a nuance of ‘putting down’ those with open minds and of differing views. Absolutely no influence can be borne to those who have intransigence and sarcasm in their character.

            Just for the record, try as I might to ignore Professor Ernst’s blog, I am drawn back just to see how the ‘flavour’ is panning out : well it is pretty predictable. The same group of sceptics have no intention of ‘listening’ to others’ viewpoints. But just for the record, too, I have not changed my mind about my experiences of Chirooractic, homeoopathy, Reiki, Acupuncture etc – they stand the test of time – my health and my choice.

            Jens thank you so much as I have learnt much from your posts, truly enlightening. I hope your future entanglement with us Brit’s is a more pleasant experience. My husband spent many years in Norway in hiis engineering career, so I know first hand what a fine nation you are. And – congratulations – your English is first class : I wonder how many English speaking posters on this blog speak Norwigian; and I know from experience it is not an easy language to learn – well for me anyway.

            The ability to be superior and ‘always right’ is global, but a fair amount of those with this ability comment here. Please don’t view us all in the same light. And in ‘the light’ Jens I wish you and your family health and happiness And thank you for your valuable posts on Chiropractic.

          • Jens,

            As English is a second language to me, I cannot cleverly use words like drones and dullards, to which their behaviour are comparable to.

            So, I am quite certain that my info gradually will sink in, unless they are totally … imbeciles?

            Yet you feel entitled to create and/or use terms such as “TICL” and “PAI”, and make statements such as “… This effect is physical and therefore possible to measure with a PAI. Thus, you need a PAI + a chiropractor to reproduce my findings – not a double blind test.”

            1. It is impossible to determine the precise horizontal alignment of the intercristal line [the line joining the superior aspect of the iliac crests posteriorly] using either palpation or an external spirit level: for reasons that should be obvious to everyone who has studied — and has properly understood — anatomy.

            2. It is irrelevant whether or not the iliac crests are in perfect horizontal alignment because this does not, and cannot, take into account bone growth asymmetry in the ilium.

            3. Every person who has even the slightest level of asymmetric bone growth in their legs or their ilium cannot possibly be in an ideal upright ‘gravitational’ homeostatic state when their iliac crests are in perfect horizontal alignment.

            You might be able to get away with fooling some of the people, some of the time, but you are very much mistaken to suggest that I am an imbecile because I’m seriously questioning your ‘info’ and your pseudoscientific methods. It is you, and only you, who owns the burden of proof for your assertions, including the clinical efficacy of your medical gadgets.

          • @Jens

            Please don’t stop posting. Despite Edzard’s obvious distaste(hate?) for most things non-medical, he does run a fine website and blog. Although many of the usual posters keep their eyes “wide shut” regarding paramedical clinicians and their blog posts, there are occasional posters who will read your statements with open minds. They might subsequently respond with either criticism(likely) or support(less likely), but they won’t insult you for expressing your views and experiences.

  • I don’t think you can claim the survey suggests *anything* when the response rate is 2.6%!

    There might be growing scepticism, there might be the complete opposite. But whatever is happening this survey won’t tell you.

    I’m a little gobsmacked you glossed over this aspect and concluded so strongly that the results indicated something at all – eve if it is a result that “cheers you up”

    • @ Jon W

      From a recent paper in a chiropractic journal:

      “The use of chiropractic services has stalled”

      Ref: https://www.ncbi.nlm.nih.gov/pubmed/27920613

      • @ Jon W

        I would add that most scientifically-minded healthcare professionals, and members of the public, are likely to take a dim view of the relentless in-fighting and flip-flopping between the different chiropractic tribes – e.g. the President of the British Chiropractic Association has, this month, performed a spectacular U-turn (from the Association’s previous, recent stance here https://web.archive [DOT] org/web/20140331222707/http://en-gb.facebook.com/note.php?note_id=153048378097052 ) by declaring that the chiropractic industry is “stronger acting together” and that there can be “unity without uniformity” within a single association:
        http://chiropractic.prosepoint.net/144414

        Also see:

        UK chiropractic “faces an existential threat” (p6)
        Ref: chiropractic-uk.co [dot] uk/download/CONTACT_SUMMER2016_LR.pdf

        More UK chiros retiring than joining the trade (p6)
        Ref: chiropractic-uk.co [dot] uk/download/CONTACT_SUMMER2016_LR.pdf

        And then there’s this to consider:

        NICE guidelines for low back pain and sciatica: a clarification

        QUOTE:
        One important point from this guidance is that NICE recommends a “group exercise programme”. This presents something of a problem for pure manual therapists such as osteopaths and chiropractors as they don’t normally have access to a group exercise programme for their patients. I have already highlighted the fact that osteopathy and chiropractic are no longer first line treatment choices for low back pain and sciatica. NICE have made it clear in their own press release that exercise is the “first step in managing the condition”. The right person to deliver an exercise programme is of course a physiotherapist.
        Ultimately, the purpose behind these guidelines is to bring about improvement in care for patients. Views such as “Osteopathy or manual therapy continues to be the treatment of choice for low back pain with the proviso that it is provided with exercise” give an interesting insight into the goals of the osteopathic profession. This statement is far too obviously in conflict with the guidelines to be a mere “misunderstanding”. These kinds of statements appear to be more focused on promoting the businesses of the osteopaths. In so doing, osteopaths seem to have forgotten the most important thing of all: looking after the best interest of their patients.
        The new NICE guidelines are something of a problem for osteopaths and chiropractors as their treatments are no longer first line choices and they are not well placed to offer a suitable exercise programme. Some of them may opt to continue treating patients the way the always have and not take the NICE guidelines into account. However, that is a potentially risky strategy for two reasons:

        1. It doesn’t seem to be in the best interest of their patients
        2. They risk being found in breach of their “Practice Standards” which could result in formal complaints to either the GOsC or GCC.

        Ref: https://complementaryandalternative.wordpress.com/2016/12/06/nice-guidelines-for-low-back-pain-and-sciatica-a-clarification/

        • @BW
          The latest NICE guidelines endorse a multi modal approach which most chiro’s, osteo’s and physio’s use!
          Vitalist chiro’s who thing SMT is a universal panacea are being left behind!
          I think it will be crunch time for the vitalists within the next 5 years and there is a growing backlash within the profession to The Rubicon Group!

        • @ Blue Wode

          With regards the NICE guidelines, I think Adam Meakins sums it up nicely:

          “Lets also not forget that these are only guidelines, and so are going to be open to everyones interpretation. Exercise advocates will focus on and emphasis the exercise bits (just to be clear again, I’m an exercise advocate). Manual therapy advocates will focus on and emphasis the manual therapy bits. Psychological advocates will focus on and emphasis the psychological bits. Acupuncture advocates will focus on and… oh hang on… no one really cares about what they think any more!”

          Have a read of the article he wrote on his blog (https://thesportsphysio.wordpress.com/2016/12/01/my-agenda/) – I think it might help!

          • @ AN Other

            Yes, I expect that chiropractors and osteopaths, in particular, will be quite creative with their interpretation of the new guidelines. IOW, the will add their own prejudices into the mix at the expense of their patients’ time, money, and – in some cases – lives, otherwise their livelihoods (most work in private practice) would be threatened.

          • @AN Other
            The blog post from Adam Meakins makes interesting reading. However, taking just the quote you did and posting it out of context misses much of the point of the article. When read in its entirety, manual therapy is very clearly not put on a par with exercise. For instance, he says “when I do use manual therapy, just as the guidelines state it most certainly is only ever with exercise or education, and only because the patient has expressed high expectations or preferences for it, and only then if I think it will not cause a loss of self efficacy, or develop a reliance, or reinforce any false or negative beliefs.” and “And unless strong robust evidence tells me other wise, I will always continue to steer people away from all the passive interventions, such as manual therapy, electrotherapy, needles, tapes, braces, corsets, injections etc and direct them towards increased physical activity, behaviour and lifestyle changes, and ultimately self management.”

            When considering who’s views to follow, the message from the authors of the guideline itself is obviously the most important. In their press release (https://www.nice.org.uk/news/article/nice-publishes-updated-advice-on-treating-low-back-pain ) about the new guidelines, NICE make it very clear that exercise is the first line treatment:
            “NICE’s updated guideline on low back pain and sciatica recommends exercise in all its forms – for example stretching, strengthening, aerobics or yoga – as the first step in managing the condition.”

    • I am devastated to hear that your gob was smacked!
      Perhaps you read the very first paragraph of my post again; there you will find my reference to “several methodological shortcomings” of this survey. why do I nevertheless think that its findings are worth reporting? because there is a mountain of supporting evidence – or don’t you agree that
      recent chiropractors had a ‘bad press’ and loss of reputation (for instance, the BCA’s libel action against Simon Singh)? that
      the work of sceptics in informing the public about the numerous bogus claims made by osteopaths and chiropractors might show some success?
      that a plethora of overtly bogus claims continues to be made by these practitioners on a daily basis?
      a more general realisation might have occurred that these therapies can cause very serious harm?

  • But… but… We are repeatedly told by chiros who comment on this blog (including at least one from Australia) that GPs and other medics frequently refer patients to them. They give us an impression that they are a valuable ‘medical profession’. This constitutes one plank in the case chiropractors make for recognition as ‘primary care physicians’.

    Are these good folk just giving us unverified anecdotal nonsense? Surely not! The survey must be wrong.

  • By the way… the sums we have to complete to prove we’re human when posting a comment now include Roman numerals and numbers spelt as words, yet when I try to respond in kind, the system rejects my Roman numerals and words. It’s obviously one rule for the system, another for its users! 🙂

  • I would add: “The slow but inexorable secularisation of Western thought, philosophy and the practical applications of faith – that is, withdrawal from belief in unorthodox systems of medicine which have no plausible evidence of support from evidence-based scientific enquiries.”

    In other words, the world is moving on.

    • @Dick

      You wrote, “The slow but inexorable secularisation of Western thought, philosophy and the practical applications of faith – that is, withdrawal from belief in unorthodox systems of medicine which have no plausible evidence of support from evidence-based scientific enquiries.”

      Please re-read(then re-write) this group of words; they don’t form a complete sentence and are therefore largely uninterpretable. I’m especially curious as to whether you believe that Western religions’ secularization(your claim) is “inexorable” over the long term, or if you think the opposite might occur in the future.

  • It’s still shocking to me that anyone trained as a doctor would need then to be taught about the foolishness of such beliefs.

    • yes, medical schools are usually very bad at teaching the truth about alternative medicine. far too many bend over backwards to be ‘politically correct’ about the subject.

  • I do think it’s a shame how much you hate chiropractic and clearly don’t look at any of the most recent research with any interest.

    Here is a recent study done that shows how chiropractic treatment can directly change the way the brain works.
    http://link.springer.com/article/10.1007%2Fs00221-014-4193-5

    There is plenty more of this kind of research here. Just spend some time looking at recent research.

    http://chiropracticresearch.ac.nz/publications/publications-2015/

    • I don’t blame you for not being able to differentiate criticism from hate; but I do blame you for citing research that is largely irrelevant to the therapeutic claims that you and others are making on a daily basis.

    • James White- I’ m sure there is indeed lots of ‘research’ around, perhaps not all of it concentrating on some of the undoubted ways in which the brain can be affected, in some cases to the point of serious injury or death.

  • Critical_Chiro wrote on Wednesday 14 December 2016 at 23:48 : “The entrenched vitalists will probably never change and need to have reform shoved down their throats. The problem is the large block in the middle that are apathetic and in all likelihood unaware of whats going on!”

    Could it be that “the large block in the middle” are secret vitalists or vitalist sympathisers? With regard to the data I cited above (which show that the majority of chiropractors are not evidence-based), if you assume that those who responded to the respective surveys were from the more ethical end of the chiropractic spectrum, then apathy isn’t the problem.

    • @BW
      “Could it be that “the large block in the middle” are secret vitalists or vitalist sympathisers?”
      Good question Blue!
      If you look at Vitalist mouthpieces like the ASRF (Australian Spinal Research Foundation) here less than 10% of the profession are members! (They brag about growing membership but its not local) They used to have solid Australian presenters at their annual Love Fest/Religious Meeting but now its all American guru’s who have zero understanding of how the profession works here!
      The surveys from the US, Europe and Australia all show similar results so they are fairly representative of the profession Blue. I have also talked to friends who are evidence based yet are members of CAA and they were unaware of CAA’s BS, back door support of the proposed private college in Adelaide (National, Victorian and South Australian executives are involved contrary to the wishes of the national membership who voted NO to a private college) and stuff ups! CAA members need to hold their executive accountable and become more involved or vote with their feet! Will be interesting to see if they do as many are part of that large middle block!

  • @BW
    The first blog in your linked references a phone survey done by students on a handful of practices and is a very poor study! Additionally the WFC survey (2005) and recommendations had Gerry Clum as one of the three authors . He is not part of WFC now and is instead involved with The Rubicon Group! He was all about pushing and protecting the vitalist agenda and their beliefs!
    There have been a fair few papers especially recently on practice patterns, EBP, attitudes and beliefs:
    http://chiromt.biomedcentral.com/articles/10.1186/2045-709X-22-11
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4944433/
    http://chiromt.biomedcentral.com/articles/10.1186/s12998-016-0112-0
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688561/
    http://chiromt.biomedcentral.com/articles/10.1186/s12998-015-0072-9
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593039/?tool=pmcentrez
    http://chiromt.biomedcentral.com/articles/10.1186/s12998-015-0060-0
    https://www.ncbi.nlm.nih.gov/pubmed/25939556
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193988/
    http://chiromt.biomedcentral.com/articles/10.1186/2045-709X-22-13
    http://chiromt.biomedcentral.com/articles/10.1186/s12998-014-0044-5
    http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-14-51
    https://www.ncbi.nlm.nih.gov/pubmed/24237100
    https://www.ncbi.nlm.nih.gov/pubmed/20937430
    Apologies for the long list but this is an area of particular interest!

    • These papers create a clear impression that the ‘profession’ of chiropractic sets itself up as an alternative to real medicine, yet it increasingly uses the methods of real medicine. Obviously, when chiros are asked ‘do you value evidence-based medicine’ they will mainly answer in the positive. Moreover, I have at last had an answer (elsewhere) to my oft-repeated question: ‘what do chiropractors do that’s different from physiotherapists?’ Answer: spinal manipulation.

      We really don’t need two different versions of medicine. Spinal manipulation has not been particularly well studied scientifically and its benefits are dubious, to say the least. So C-C, let me say to you what I’ve said many times before, but this time in the form of a plea. If you reject, as you say you do, the nonsense from the foundation and history of chiropractic, please GIVE UP CHIROPRACTIC and take up medicine or physiotherapy, whichever you prefer. You can’t reform something by taking out the elements that make it not look like medicine without acknowledging that mainstream medicine is already offering what you claim to desire.

      • @ Critical_Chiro

        Those papers are too vague. I’m looking for data more akin to the World Federation of Chiropractic’s research which was conducted more than a decade ago for its Identity Consultation. Scroll down and click on document 5 (Survey Results) in this link to see how comprehensive it was:
        https://www.wfc.org/website/index.php?option=com_content&view=category&id=64&layout=blog&Itemid=93&lang=en

        Has there been any similar research done recently?

        NB. Sadly, the outcome of that research was framed in the most chiropractor-friendly way possible…

        QUOTE
        “On June 15, 2005, the World Federation of Chiropractic,
        at its 8th Biennial Congress, unanimously agreed that
        chiropractors should be identified as “…spinal health care
        experts in the health care system…with emphasis on the
        relationship between the spine and the nervous system…”
        This definition fails to place proper limitations on chiropractors
        who use spinal adjustments to treat general
        health problems, plunging the profession deeper into
        pseudo-science and away from establishing an identity for
        chiropractors as back-pain specialists.”

        Ref: http://jmmtonline.com/documents/HomolaV14N2E.pdf

      • Frank Odds- that would seem to be concise enough.

      • @Frank Odds
        The sad think is that mainstream medicine has handled chronic back pain very poorly! This is a common frustration of doctors, chiro’s and physio’s who I talk to! Chiropractic is not a technique or a single approach Frank! Evidence based medicine and evidence based practice is about change and going where the evidence leads us. There are entrenched dinosaurs in physiotherapy and chiropractic and there are those who follow the evidence and this last group from both professions are ultimately heading down the same path! So it then boils down to no one can help everyone and no one profession has all the answers. That is why I work WITH doctors, physio’s, specialists, exercise physiologists etc!
        You seem to think that without subluxation dogma there is no chiropractic. This view matches the hard core vitalists within chiropractic and makes both of you incapable of change! Are you capable of supporting reform and reformers within the chiropractic profession?
        @Blue Wode
        “Why didn’t they stop Clum’s vitalist agenda?”
        Another good question Blue!
        The vitalists have repeatedly called for “unity with diversity” which in my book is just a plea for silent acceptance/endorsement! I don’t accept maintenance of the status quo! Gerry Clum has left WFC (Was their president for years) and is now with Rubicon but I do not know the details.
        I think you are also looking for the recent SOFEC position statement that came out of the WFC conference in Athens!
        http://vertebre.com/charte-pour-l-education-chiropratique-en-europe-8163

        • Critical_Chiro wrote: “The vitalists have repeatedly called for “unity with diversity” which in my book is just a plea for silent acceptance/endorsement! I don’t accept maintenance of the status quo!”

          @ Critical_Chiro

          You seem to be in a tiny minority there – e.g. just this month, the President of the British Chiropractic Association declared that “unity need not mean uniformity”
          http://www.mccoypress.net/i/bca_bennett_letter_december_2016.jpg

        • Are you capable of supporting reform and reformers within the chiropractic profession?

          Nope.

          Your reason for the continuation and existence of the chiropractic ‘profession’ is that “mainstream medicine has handled chronic back pain very poorly”. A quick search of Medline shows there were 1817 scholarly publications over the past three years with the words ‘chronic’ and ‘back’ and ‘pain’ in the title. Just 55 of these had ‘chiropractic’ or chiropractic manipulation’ in the title or keyword.

          It seems to me that (a) mainstream medicine is certainly at the very least trying to get to grips with chronic back pain and its many causes far more earnestly than chiros and (b) that you don’t solve medical problems by starting a ‘profession’ based on ridiculous ideas alone, whether or not people come along over 100 years later and try to reform those ideas.

          Evidence based medicine and evidence based practice is about change and going where the evidence leads us.

          This is a hoot-out-loud comment; ROFL in webspeak. Why don’t you start by following some of the evidence in those 1817 publications? The evidence for chiropractic efficacy in chronic back pain is pathetic (see http://edzardernst.com/2016/03/nice-no-longer-recommends-acupuncture-chiropractic-or-osteopathy-for-low-back-pain/).

          C-C, it is you who is blinded by your friendly association with doctors, physios and others grateful to offload patients for whom they can, as yet, offer little or no help from medical science. Please do realize that the help you offer is precisely the same as that of acupuncturists and ministers of religion. You all fool yourselves into imagining that your ‘successes’ with some patients are true medical advances; but you are all quacks, pure and simple.

  • @Frank Odds
    You cite numbers but fail to look closer! I shared your beliefs until the 2008 Special Supplement of The Spine Journal where Scott Haldeman got leaders in the field from 25+ different approaches to write a review and then he collated the evidence. It was a big eye opener!
    See here:
    https://www.ncbi.nlm.nih.gov/pubmed/?term=Evidence-informed+management+of+chronic+low+back+pain+with
    I then became equally cynical with the medical approaches for chronic low back pain! You should take the time to read these articles!
    Are doctors happy to offload difficult chronic backs? Yes! One thing you fail to understand is the dynamics of the medical referral system. If a doctor refers to me and I do a good job the patient is happy with the doctor NOT me. If I stuff up then the patient is pissed off with the doctor not me! Referrals reflect straight back on the doctor and they do NOT refer lightly! Am I offering a placebo? You bet your sweet pippy I am and it is called the psychosocial model of pain. I am very careful how I interact with patients as the nocebo effect is just as important if not more!
    “but you are all quacks, pure and simple.”
    Carpet bombing entrenched critics are just as much of a problem as the entrenched evangelical vitalists when it comes to reform!
    @Blue Wode
    Appeasing the evangelical vitalists is not in my blood Blue! They try to water down reform but ultimately it will roll over the top of them! BCC is trying to bring them in from the cold but if they are not prepared to reform then it will a waste of time. Reform is inevitable and I would rather be at the table and part of the discussion!

    • Critical_Chiro wrote: “Reform is inevitable”

      I wouldn’t bet on that. For example, this is what the future is likely to look like in the USA:

      QUOTE
      “…if chiropractic fails to specialize in an appropriate
      manner, there may be no justification for the existence
      of chiropractic when there are an adequate number of
      physical therapists providing manipulative therapy. Many
      physical therapists are now using manipulation/mobilization
      techniques. Of the 209 physical therapy programs in
      the US, 111 now offer Doctor of Physical Therapy (DPT)
      degrees. Some of these programs have been opened
      to qualified chiropractors. According to the American
      Physical Therapy Association,
      …Physical therapy, by 2020, will be provided by
      physical therapists who are doctors of physical therapy
      and who may be board-certified specialists. Consumers
      will have direct access to physical therapists in all environments
      for patient/client management, prevention, and
      wellness services. Physical therapists will be practitioners
      of choice in patients’/clients’ health networks and will
      hold all privileges of autonomous practice…”

      Ref: http://jmmtonline.com/documents/HomolaV14N2E.pdf

      Re the British Chiropractic Association “trying to bring them [the vitalists] in from the cold”, that was achieved over two decades ago, but its success was very short-lived:

      QUOTE
      “In spite of strong mutual suspicion and distrust, the profession united under a group formed specifically to pursue regulation and secured the Chiropractors Act (1994)…..Regulation for a new profession will literally ‘legitimise it’, establishing its members within the community, making them feel more valued. In turn, this brings greater opportunity for more clients and a healthier bank balance.” Michael C. Copland-Griffiths, former Chairman of the General Chiropractic Council (European Journal of Oriental Medicine, Vol.2 No.6, 2004)

      Ref: http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1437-statutory-regulation-the-chiropractic-experience.html

      Critical_Chiro wrote: “I would rather be at the table and part of the discussion”

      The discussion is over. IMO, you should leave the table and the chiropractic industry.

    • “Am I offering a placebo? You bet your sweet pippy I am and it is called the psychosocial model of pain. I am very careful how I interact with patients as the nocebo effect is just as important if not more!” So (for the umpteenth time) why associate with a ‘profession’ that’s based on quackery?

      You’ll use your stock ‘carpet bombing’ complaint again, I’m sure, but you simply fail to comprehend: patients don’t need an alternative to medicine. The world doesn’t need 6, 12 or 55 different systems of medicine (I can’t count the quackery since most of the alternatives claim to ‘help’ or ‘treat’ the same conditions).

      I’m happy to believe that some kinds of spinal manipulation can help relieve some conditions, but for goodness’ sake get the evidence first, then by all means set up a sub-discipline of medicine based on that evidence. If I told you I’m a reformed flat-earthist, what would you think? That’s why I can’t accept the concept of a ‘reformed’ chiropractor.

      • @Frank Odds
        “So (for the umpteenth time) why associate with a ‘profession’ that’s based on quackery?”
        Never adopted or went down the vitalist path so I am not a reformed chiropractor! I am more of a cynical critical chiropractor! The vitalists adhere to the outdated quackery because their business model would fall apart if they practiced ethically! The rest of us moved on many years ago! You need to make the distinction and be more targeted in your criticism otherwise the “carpet bombing” analogy is an apt description! Critics are essential for reform and I look on this forum as ultimately helping reform. The frustration is when you guys take out the reformers as acceptable collateral damage!
        “patients don’t need an alternative to medicine. The world doesn’t need 6, 12 or 55 different systems of medicine”
        The world needs its health care providers to communicate with each other and be on the same page coordinating the patients care. Medicine has stuffed up when it comes to chronic back pain so patients need chiro’s and physio’s who follow the evidence and provide evidence based care! Creating a toxic dependency in patients for mythical subluxations is a different kettle of fish and you would probably be surprised that we are in agreement on this issue!

  • #Blue Wode
    A very public split or cleansing of the profession is probably on the cards within the next 5 years! If not insurers and regulators will place restrictions on how a chiropractor practices! Either way the vitalist model of practice is going to change and some will be in for a shock!

    • Changing the vitalist model of practise is not going to change the vitalist beliefs of the practitioners.

      • @Pete Attkins
        Probably not but shoving reform down their throats will probably be the only viable option as they will not change willingly!

        • Critical_Chiro,

          I totally agree 🙂

          Please don’t think that I’m in any way trying to belittle either you personally or your much-needed reformation work. I’m struggling really hard to understand the long-overdue reformation of the whole alternative-to-medicine (sCAM) empire.

          E.g., if we were to reform reiki by removing the nonsense ‘energy’ aspect, what could possibly remain that would support the branch of reiki staying attached to the tree of alt-med?

          Similarly, if we were to reform homeopathy by removing the nonsense of both “like cures like” and ‘remedies’ that contain no molecules of the original substance, what could possibly remain that would support the branch of homeopathy staying attached to the tree of alt-med?

          It seems to me that, if each and every branch of the tree was pruned to remove all of the abject nonsense, then all that would remain is a useless and unsightly tree stump — a nocebo, not a placebo.

          Sincerest best wishes and Happy New Year,
          Pete

          • Thanks and Merry Christmas and Happy New Year to you, too, and also to everybody participating in this blog (including those mocking me for my use of poor English language). 😂

            Hopefully, chiropractic therapy sooner or later will become reformed according to my findings, which I believe to be a postural frame of reference showing recuced postural loading conditions when the TICL has become perfectly horizontal after therapy. Till then, my offer for freely supplying a manually operated Pelvic Angle Indicator (PAI) stands.

          • Sorry! I saw it too late that the comments that I answered were not for me. I guess I am too old for this kind of blogging and will remove myself from further participations. …

  • Critical_Chiro: I think it will be crunch time for the vitalists within the next 5 years and there is a growing backlash within the profession to The Rubicon Group!

    hmmmm …. There’s been a “growing backlash” within the next five years ever since I graduated chiropractic school in the “Orwellian” year of 1984. Maybe you’re doing chiropractic math. While I certainly wouldn’t characterize any so-called reform efforts as a “backlash,” it’s true there are some chiropractors who do try to be heard above the persistent and uncontrollable Subluxationist din of their colleagues. But, there’s simply too much chiropractic noise and resistance to science and medicine to move the chiropractic equation significantly to the right … at least in a timely enough fashion that the chemical reaction you’re predicting will ever “go to completion.” The fact is, the chiropractic profession has been going on the gas and the brake simultaneously ever since chiropractors wanted to be called “doctor” and bill insurance for their Chiropractic Spinalism.

    Because chiropractors have been chasing their own “tale’ since 1895 and still don’t want to give up their Chiropractic Ghost — even in 2016 — you’ll notice that the bulk of so-called ‘more medical” chiropractors continue to Look to the Spine as the first order of chiropractic business. Thus your average chiropractic fig newton acts as if “joint dysfunction” and “spinal lesions” are not simply a rebranding of the same old Chiropractic Subluxation — a Chiropractic Rose by another name.

    So, having heard from defended chiropractors for over 30 years arguing that “things are changing (you’ll see),” that “Chiropractors are doctors too (ya know),” and that “reform is just around the Chiropractic Corner (in the next 5 years),” I suggest that you have already waited too long for your Chiropractic Gadot to show-up. I’m afraid the vote’s already in.

    My recommendation is to pack-up your diploma and plastic spine and take the first train out of Chiroville. Honestly, efforts to dig your way out of more than 100 years of Chiropractic Oobleck are Sisyphean. For every Critical_Chiro promoting a physiotherapeutic version of “chiropractic,” there’s two to three chiropractic meatballs selling and serving the Pure Chiropractic. In other words, your “backlash” hasn’t even reached a chiropractic garbage in, chiropractic garbage out steady-state … and likely won’t in your lifetime.

    ~TEO.

  • @John Badanes
    You think that there is too much inertia and resistance to change within chiropractic and that reform can never be completed! In your day the vitalists went unchallenged and felt secure. That time has definitely passed and they now feel threatened and under siege. The circling of the vitalist wagons with the Rubicon Group (The few remaining vitalist colleges) is a good example. When I discuss the vitalists having reform shoved down their throats it will not be from within the profession but from regulators and insurers with evidence based chiropractors giving them a helping hand. This is already occurring and is accelerating!
    Scott Haldeman recently discussed this topic at a conference and chiropractic is not immune from the changes currently sweeping through medicine. The “Pure Chiropractic” business model days are numbered. If they do not change they will be in for a rude shock.

  • @John Badanes
    A quick Google Search explain a lot! Being at Life under Sid Williams you have drunk the kool-aid, swum in it and drowned in it! After they lost accreditation you would have thought that things would change but with Guy Reichman at the helm?? Your hatred of the chiropractic profession is understandable!
    The forces now gathering momentum both within and without the profession make reform inevitable! The only question is what form it takes!
    Merry Christmas and a Happy New Year to all on this site!

    • Critical_Chiro: A quick Google Search explain a lot! Being at Life under Sid Williams you have drunk the kool-aid, swum in it and drowned in it! After they lost accreditation you would have thought that things would change but with Guy Reichman at the helm?? Your hatred of the chiropractic profession is understandable!

      Well, this is the sort of reply I get from a chiropractic meatball whenever I point to an open fly in the chiropractic profession’s pants. Was it something I said? Why, of course it was. But what was it that bothered you so? 🙂

      It seems that I have given you considerably more credit where credit is [actually] chiropractic doo. Because you are a chiropractor who has been arguing that “chiropractic” will be unrecognizable in five years after some unspecified reforms have been implemented AND because you represent yourself here as [a] CRITICAL_chiro, it seemed reasonable for me to think you were, at least a little bit CRITICAL of “chiropractic,” chiropractors, and the chiropractic profession. My mistake. It turns out you’re not critical of what chiropractors think, say, and do professionally unless they are fully naked with antlers strapped to their head, doing one of the many chiropractic antler dances.

      But, this is no more a criticism of “chiropractic” than pointing out that rubbing cow-shit on a patient’s thighs is unlikely to manage their glaucoma. Worse, and more to the point of cogent criticism of chiropractic personality and culture, by pointing to your sick chiropractic cousins, the suggestion is that the remaining chiropractic family who are not antler dancing are all about something significantly more legitimate … you know, the ones who diagnose and treat “Spinal Dysfunction,” for example. If that’s so, what specific “dysfunctions” would you be referencing and how is each specific chiropractic treatment directed at fixing each of those named “dysfunctions?”

      In other words, since you are a CRITICAL_chiro, what are your criticisms of “chiropractic” and chiropractors? What, for example, is wrong with the “chiropractic” that Dr Kjersem has gotten all over the carpet here in this thread? No criticism from a CRITICAL_chiro? Maybe you agree with his proprietary “chiropractic” and plan to purchase an inclinometer. Or maybe you are just showing respect for a chiropractic colleague and don’t want to rock the Good Ship Chiropractic. I thought you were a Critical_chiro., though. I don’t know, but do you see a Dr Kjersem as part of your five year plan? How do you expect to clean a chiropractic house if you can’t level simple and cogent criticism of what’s wrong with even his simplistic chiropractic musings?

      Sorry if you’ve mentioned any of this before, but what’s your name and where do you practice in Australia? Is it a problem for you to offer these basics or are you in some sort of danger from colleagues if you speak-up with your criticisms of “chiropractic” and the Chiropractic Enterprise. That would be the very definition of a KoolAid culture, wouldn’t it 🙂

      Critical_chiro: Whenever I get a new patient who has seen a faith based chiropractor I tell them that I do not practice that way and why!

      So, what DO you practice and why don’t you practice “that way?” What do you tell the patient who’s moved to your town and comes from a NUCCA practice with a complaint of low back pain?

      So far, my recommendation for any chiropractor who knows which way is up in a Chiropractic Byzantium remains that they pack their diploma and plastic spine and take the first train out of Chiroville. In other words, what’s the BEST you can hope for with your chiropractic license? Once you’ve eliminated everything that is uniquely “chiropractic” — the Vertebral Subluxation and the panoply of Adjustments purported to “correct” these chiropractic fictions — what’s left for you to practice, if not some version of a limited physiotherapy. Do you really think it’s worth digging yourself out of more than 100 years of chiropractic oobleck as I described earlier so that you to end up being a poorly trained physiotherapist, doing physiotherapeutic things, but as a chiropractor?

      How old are you?

      ~TEO.

      • John Badanes
        I’ve always, in the same way, found people who call themselves ‘lapsed’ or ‘non-practising’ Catholics rather strange, not to say duplicitous.
        Which? One or the other.Catholic or not Catholic? Pregnant or not pregnant? No such thing as ‘well, kind of pregnant’.

  • I see that Illogical Bias has returned to the fray! What larks, Pip!
    Albeit he- as I said before-is a bit too far off the scale for me to bother engaging with.
    Still, always interesting to see his lies and misrepresentations. It’s as edifying though as watching a mouse skiing.

  • Dear Alan,

    You list 3 reasons putting down my arguments. Here are the answers:

    1. The comments to Frank Odds and his co-bloggers from Jens Anders Dag Kjersem on Tuesday 27 December 2016 at 19:47 may provide you with some embarrassment (if you are capable of that), as factual physical observations with an anatomical spirit level show that you have not properly understood – not just functional anatomy – but also human physiology. That is embarrassing!

    2. You ought to know that it is not irrelevant whether or not the iliac crests are horizontally aligned. The reason is that normal functions of homeostasis seek to maintain the iliac bones in perfect horizontality in order to produce an ideal horizontal weigt-bearing plane of the upper pelvis reducing poor loading condition in the area of greatest loads.
    After measuring 896 patients, all of who probably had various normal and abnormal deficiencies in greater or lesser degrees, it showed that it does not matter whether their bones were asymmetric in shape and size. The pelvis produces torsion in order to achieve perfect TICL horizontality and the rest of the postural articulations assumedly co-compensate very slightly in order to achieve both horizontal TICL perfection as well as reduced loads against all articulations. This function naturally reduces pain. You therefore owe all ethical chiropractors a deep bow with an excuse for ridiculing them so stupidly.

    3. Yes, they can! The erect posture (body) adapts to the most ideal weight-bearing positions with a perfectly horizontal TICL. And, if you do not like shortened words, I can write TICL fully, Transvers Iliac Crest Line. This line is always measured with its torsion and therefore on the highest points of the iliac crests. When the pelvis has great torsion, this line becomes more diagonal, but still perfectly horizontal.

    And, Alan, I am not fooling you, not even for a second. Whether you choose to act like an imbecile or not is up to you. In my answer to Frank Odds and co-bloggers yesterday night, you probably cannot get more proof from me than that. You may have to convince yourself that I say the truth or get a physical demonstration with a spirit level showing that posture instantly compensates when leg lengths are changed, also with the use of a TPH or Trigger Point Hammer and a TC or TriggerCiser (clicky sticks). In fact, the TPH or TC may actually treat an erect person with a diverging TICL, who has a PAI mounted on him/her, and instantly observable (with a PAI) produce a perfectly horizontal TICL in that person. Can you ask for better and more convincing proof?

    Sincerely,

    Jens Anders Kjersem, DC
    jensadk@gmail.com
    +47 900 38 545

    • Jens- Happy New Year!
      I just looked up ‘Trigger Ciser on the Internet, it being new to me.
      I must admit it, I can’t stop tittering!
      It’ s a device described as an ‘Italian Wellness Solution’.
      Private Eye magazine in Britain is very good at taking the piss out of this wafts kind of language. In the 70s they invented something called ‘Neasdiloaf bread- style substitute’, from Neasden.
      The current version seems to be ‘artisan bakers’ or similar.Or even worse, ‘artisan style’.
      What exactly -or even approximately- is a ‘wellness solution’?
      The only thing that would sound funnier is ‘Wellness style solution’.
      Proof, were it needed, that style is as important as content.

      • Italian Wellness Solution, SRL is the new name for Cojeda, SRL (www.cojeda.com). This is an Italian business who buys TPHs and TCs from me and then sell them to whoever wants to buy them. This company also conducts seminars teaching anyone who wants to use them in practice as a clinical instrument. I taught at a few seminars, but now they do it on their own. How they conduct seminars today, I do not know, but I know that medical doctors have attended, too. When testing these instruments (click sticks), I had to order quite a few from the steel factory in order to get a lower price, but as they were sold for just above costs, they became very popular so I had to re-order. To me, these instruments are really not a business, but in my clinic they have worked fine as clinical aids (as you may have understood from my English with so many faults). This company does not supply the PAI or the LLR, but I still have just a few left in my garage. However, if the company wants to, I can set them up with the steel factory so they may order any instrument directly. I just have not made them that offer yet, but I will.

        • Jens- all of which is moderately gripping.
          ‘Wellness Solution’ is still hysterically funny though.
          A bit like promoting food as a ‘hunger- style solution’.
          A case of ‘style’ giving away a clue as to ‘content’, or- in this case- lack of.

    • 1. The comments to Frank Odds and his co-bloggers from Jens Anders Dag Kjersem on Tuesday 27 December 2016 at 19:47 may provide you with some embarrassment (if you are capable of that), as factual physical observations with an anatomical spirit level show that you have not properly understood – not just functional anatomy – but also human physiology. That is embarrassing!

      Making an appeal to authority [argumentum ad verecundiam] is usually just a pathetic fallacious argument that is unworthy of a reply.

      Making an appeal to your own authority, not just in the absence of scientifically peer-reviewed replicated empirical evidence, but also in conjunction with your statement “but this is not evidence-based testing; it is physical testing controlled by the force of gravity” is way beyond excusable: it demonstrates a potentially dangerous level of disgraceful incompetence in a person who claims to have obtained a doctorate — especially in medicine.

      Thus far in the comments, you have clearly demonstrated that: you have no idea how to copy and paste words and phrases; you have no idea to whom you are responding; you don’t simply reject the scientific method, you have the audacity to mock it, and those who comply with it; and that you have deeply vested interests in constructing, marketing, and promoting products for chiropractors.

      I don’t give a rat’s arse what you think of me personally, neither do I give a rat’s arse if you write comments that attempt to discredit me. Why? Because you are the one who totally owns the burden of proof for your many claims and diatribes. You might be able to get away with making your claims via a retailer in Italy, but certainly not under UK legislation.

      Thank you for clearly demonstrating this insidious creep of quackery.

      I shall not reply to your other points because you refuse to accept science, its methods, and its well established terminology.

      • I can only show that I can copy Logos-Bios comments on Thursday 29 December 2016 at 23:38:

        “You will be unable to convince that hypocrite that he’s a hypcrite.”

        If you do not understand that, I can confirm that the hypocrite is referred to you!

        • Jens,

          You seem to be terribly confused. I shall use the principle of charity during this festive season by assuming that your confusion is the result of consuming ethanol-laced beverages.

          For the readers who are not terribly confused, I shall simply state that my name is not Alan — the name by which you addressed me on Wednesday 28 December 2016 at 19:52 — my name is Pete.

          This is the reason that I wrote in my reply: “you have no idea to whom you are responding”.

          Frank Odds was correct: “I’m sorry; you’re a loony.” Many thanks, Jens, for your confirmation 🙂

    • Al only requires absolute proof of a procedure/method when such is utilized/practiced within a paramedical disclipline. He gives such requirements a pass when less-than-airtight research, or infinitesimal amounts of research, exist for medical procedures(e.g. off-label prescribing). You will be unable to convince that hypocrite that he’s a hypcrite. Al is good for a few laughs, though.

      Be well

      • Logos-Bios said:

        Al only requires absolute proof of a procedure/method when such is utilized/practiced within a paramedical disclipline [sic]. He gives such requirements a pass when less-than-airtight research, or infinitesimal amounts of research, exist for medical procedures(e.g. off-label prescribing). You will be unable to convince that hypocrite that he’s a hypcrite [sic]. Al is good for a few laughs, though.

        LOL, but please at least try to make sense when you’re attempting to be funny.

        • It would also help if L-B was funny when attempting to make sense.

        • @Al

          Unlike your oft-bastardized attempts to write in a professional, clear manner, my post to which you have commented was grammatically adequate. I really can’t dumb its thesis down anymore for you. I recommend that you re-read it s l o w l y; a light might go off in your head and you possibly will understand my clearly written comments. Then again, maybe you won’t.

          Be well

          • ROFL! Hilarious tripe.

            But your unwillingness – or inability – to answer my simple question is noted, as are your pathetic and puerile attempts at self-aggrandisement and posturing.

          • @Al

            To which “simple” question are you referring? Perhaps I should re-state this question another way to make it make more personally understandable for you. Here goes……Which simple-minded question did you allegedly direct toward me that I have not answered? Waiting…….

            Be well

          • My apologies again if it’s all proving to be much too difficult for you to follow and understand, but I really don’t think I can help you any more here.

    • @Jens Anders Kjersem on Wednesday 28 December 2016 at 19:52

      “The pelvis produces torsion in order to achieve perfect TICL horizontality and the rest of the postural articulations assumedly co-compensate very slightly in order to achieve both horizontal TICL perfection as well as reduced loads against all articulations. This function naturally reduces pain. You therefore owe all ethical chiropractors a deep bow with an excuse for ridiculing them so stupidly.”

      Is that a moment or a torsion, and, if so, how is it measured?

      • Dear Frank Collins,

        The answer to your question: Is that a moment or a torsion, and, if so, how is it measured?

        I understood that this question is about pelvic positioning and how torsion is measured. The measurement with a PAI is made on the top of the pelvic crests, just as if you are putting flat hands on top of these crests. The anatomical spirit level (e.g. PAI) must be put in top of these crests whether they change to a foreward anterior-superior (AS) position or backward in posterior-inferior (PI) position. I normal torsion, which is how the pelvis generally moves, one pelvic bone goes to an AS position while the other goes to a PI position. These positions are referring to those two very palpatory anatomical part of the posterior iliac crests (for those who are unfamiliar with this part of the anatomy, they are the bony notches of the pelvis felt at the rear). But, the PAI measurements are made further superior to those two bony notches, namely on top of the uppermost positions of the pelvic crests. Thus, the greater the pelvic torsion, the more diagonal the position of the PAI.

        (The previously posted text was unedited by me. Hopefully, this text is better understood.)

        Comments to Frank Odds and his co-bloggers,

        Yes, I am a loony, but mainly in yours and your co-blogger’s eyes; that I do not doubt that for a second. Additionally, you are all probably good at calling nicknames to a person at a hundred yards distance so you don’t get smacked. The use of “ad hominem” attacks of character and the way your co-bloggers controvert the use of English language factually express that this blog is not a very serious science forum. Possibly Edzard Ernst should have blocked you all, but then, on the other hand, he would not have any blog to amuse himself with. However, I do make mistakes, as I mistakenly stigmatized all members of Round Table Clubs. I am sorry for that. I should have mentioned that my negative experience concerned a very few specific members of Round Table Clubs, who in general is affiliated as a wonderful and good organization. On the other hand, the bloggers I have met in this forum are trying upholding to be great interpreters of quality scientific evidence, even mechanical engineering and cognitive neuroscience. The use of their critical thinking skills about their scientific methodology is however not very good at all, and neither is their use of derogative humour. However, I am personally quite sure they are capable of answering arguments with facts – if they care to, as the last “funny” member of Round Table staying in my home got drunk and wiggled his face in a fruit basket, tearing the soft juicy fruit apart. In real life, he was actually a smart man.
        To remind you, here is what was said:

        “In your many responses you convey the impression of not having a first clue about the scientific method. It’s just not enough to tell us about something. Please try really hard to understand why you’re accused of “speculation, wishful thinking and anecdotes” and “Collecting evidence to confirm your beliefs”
        “What was your control group and what were the results from it? This is a serious question because, without knowing this information, 100% success with 896 patients is meaningless. In my field of test and measurement, I would be very suspicious of my methodology if I’d designed a test that never produced a negative result. In other words, a test that always produces a positive result isn’t a test of anything at all.”

        The science of testing cannot always be used according to the Cochrane system, as physical facts are not evidence-based facts – they are incontestable facts because they are physical facts. Additionally, they will always be incontestable because they are reproducible facts (with a spirit level). In other words, each measurement with an anatomical spirit level is physically related to the force of gravity as a frame of reference. One does not need another control group for measurements related to the force of gravity. Also, when physically measuring the TICL horizontality, all patients had to hold onto the solid steel arms of the anatomical spirit level, pushing it downward and forward into their own side-flesh (love-handles) while holding it horizontally. In other words, patients held onto the spirit level after each arm of it was placed properly on top of each of the highest points of the two pelvic crests. The final positioning was actually done by each patient, who could NOT observe the result, as the meter of the spirit level was located at the rear. Consequently, each measurement was finally done by the patients and without any fault (a millimetre divergence is simple to spot with an anatomical spirit level). But, with 896 patients, a few faults would not count very much anyhow. Concerning this testing, Pete Attkins says that 100 % success is meaningless for evidence-based testing. Of course, I certainly agree with that, but this is not evidence-based testing; it is physical testing controlled by the force of gravity.

        Patients did not seek my therapy for the success of getting improved and optimally balanced posture with horizontal perfection of the TICL. They simply sought me to get rid of their musculoskeletal neck and/or back pain. And, be clear about this, improved postural balance does not get rid of pain instantly – certainly not completely right away, as an improved postural balance only reduces loads and then pain. Therefore, one can only assume that chiropractic therapy made them feel better – more or less. How long they kept the improvement of postural balance, I did not know – some of them maybe just down the street. However, I certainly helped them with their pain – then and there – instantly. But, testing the ease of pain is different from testing physical facts. So to be clear about this, pain cannot be measured physically; however, postural balance – on the other hand – may be measured against the force of gravity as a perfect frame of reference for physical measureable positions here on Earth; when a postural frame of reference relative to the force of gravity exists, postural measurements become totally different.

        Most patients require several treatments to reduce and/or finally get rid of most of their pain and my patients were no different than others. A few of my patients discontinued treatment sessions after the first session. These were interviewed on the phone. Some of them had felt instantly better and wanted to continue on their own while a few others said they felt instantly completely well. No one factually told me that they got worse or still were the same and discontinued their therapy sessions because of that. (Of course, it happens that patients are unhappy with a treatment, but usually this is mostly caused by heavy lifting or other tasks that they expose themselves to; it is usually not because of a treatment. In my own experience, the most common reason for patients discontinuing treatments is because of their economic situation.)

        Some patients with excruciating pain were labelled as hernia patients (usually later confirmed by MRI). Those in the hernia category would generally have extremely twisted postures with diverging TICLs. When stretching them out properly on a side-posture bench with a traction-move as an adjustment, it would generally instantly relieve them of much pain (not all of the pain).
        In the aforementioned hernia cases, the most remarkable view in the clinic was observing patients come into the clinic with very crooked postures and TICLs deviating from horizontal perfection. Then, when they left the clinic, they had obvious postural improvements and less pain. When they had been observed with a clinical (anatomical) spirit level, their TICLs were perfectly horizontal. So, even though they still had crookedly shaped postures, it was quite easy to observe that they had improved their postural balances. So, even without the use of a spirit level, one could easily observe that the TICL had become more horizontal within their crookedly twisted postures.
        To spot perfect TICL horizontality, one would have to use an anatomical spirit level and when checking the pelvis of hernia patients with a spirit level one could observe that within all of their crookedly twisted postures, all of them actually naturally assumed perfect TICL horizontality after therapy, though as far as an anatomical spirit level may measure details. And, an anatomical spirit level may measure with certainty down to about half a millimeter (as an ordinary spirit levels used in construction would do). However, postural changes of the TICLs were actually much greater, some of them producing improvements of several centimetres. (In the years after 2008, I discovered that neck pain (subluxations/dysfunctions/trigger points/etc.) was generally (not always) associated with smaller TICL divergences, while pain syndromes in the lower back were associated with rather large TICL divergences. (I can only assume something, but I cannot explain these factual findings, yet.) However, it is both amazing as well as very strange to look at a person, who has a crookedly twisted posture, which compensate for the destruction of a herniated disc while the TICL stays perfectly horizontal after therapy.

        One must be quite clear about this:
        Even though chiropractic adjustments were not made in the pelvis, but in a different area with dysfunctional tissues, the upper pelvis still naturally assumes perfect TICL horizontality after proper therapy. The only hypothesis I have to offer for this natural physiological reaction is that when sensory receptors are triggered in dysfunctional tissues, posture will be able to assume perfect TICL horizontality along with improved weight-bearing loads of all postural articulations. Therefore, postural balance produces small corrections throughout all postural articulations in order to reduce weight-bearing loads against them while at the same time it produces an upper pelvic plane in perfect TICL horizontality where loads are greatest.

        Nevertheless, most patients returned to my clinic – generally after 2 days. Unless patients had extremely excruciating pain, I asked them to return every day in order to continually maintain optimal postural balance for natural healing purposes. However, on the patients’ second visit, I discovered that about 50 % of those, who had gotten a perfect TICL horizontality after therapy, maintained their new TICL-positions in a perfect horizontality. Ordinarily, it took about 2 to 4 treatments until most patients with diverging TICLs assumed a stable TICL in perfect horizontality.
        My subjective impression of the treated patients was that they in general felt less pain and less pain as the horizontal TICL perfection stayed put and got more stable. Those patients, who seemingly (still subjective value) most quickly got a stable perfectly horizontal TICL, generally after 1 – 4 treatments, were also those who responded best by reducing pain; thus, they seemingly also became soonest painless after therapy.

        My measurements showed that 70 % of the 896 patients had a diverging TICL and around 90 % of these patients got perfect TICL horizontality fairly quickly after few treatments with ordinary chiropractic therapy. However, for the remaining group, which was about 10 % of the 70 % – group, the TPH/TC (clicky stick) was used for therapy. I assumed that these patients would respond well to my special pushes (stamping thrusts with mobilizing arm movements holding the TPH/TC). The pushes included high velocity percussive thrusts of the trigger mechanism of the TPH/TC causing a vibration of the tissues while the arm movements grossly and directionally moved bones.
        The 10 % group were more resistant to postural changes, but as the TPH/TC could trigger several tissue areas at the same treatment, even inconspicuous tissues, the percussion instruments were able to trigger postural changes and perfect TICL horizontality in tissue areas, which were not always simple to find.
        By using the TPH/TC against many areas in the same treatment, affected tissues/bones, which otherwise would be hard to find and stimulate, could be treated in the same treatment in a way, which were impossible to do with chiropractic adjustments. Then, after each treatment or while performing the treatments, postural balance could be checked and re-checked with the clinical spirit level in order to see whether or not postural balance had produced changes with a perfect TICL horizontality. The aforementioned way of clinically using the TPH/TC and the PAI together was great.

        To be clear:
        When a TPH/TC (Trigger Point Hammer/TriggerCiser or “clicky sticks”) is used against tissues, like bones/articulations with ligaments and tendons, the blow to healthy tissues would be similar to a firm clap on the shoulder, which regains normality soon. However, when treating affected tissues, the TPH/TC will trigger latent (dormant/inactive/dysfunctional) sensory receptors and activate them.
        After using these instruments for many years, I can state as an empirically based fact:
        Only too much TPH/TC therapy against affected tissue will produce trauma and generally – at the most – such trauma do not last for more than two or three days. In order words, the TPHs and TCs are very safe therapeutic instrument.

        Even against perfect scientists who hold onto a belief-system of disapproving “clicky sticks” without even knowing them well enough, I have – as the loony that I am – assumed that the mobilizing arm movement holding the TPH/TC to make percussive thrusts and percussions would transfer energy by mechanotransduction into the specifically selected tissue. I therefore took the liberty to call this therapy for SMT-Therapy or Specific Mechanotransduction Therapy, as heating these specific tissues and mobilizing them, was done to make dysfunctional sensory receptors start responding, producing an improved postural balance with a perfectly horizontal TICL. Possibly, that is too far-fetched for such a “scientific belief-system”, but it is (hypothetically) perhaps the best explanation for what takes place when using the TPH/TC (clicky sticks).

        Except for 8 persons, all the TICLs of 896 patients, also those in the last 10 % – group, became perfectly horizontal. Concerning the 8 patients whose postures I could not change immediately, I recalled them later and found that they had large anatomical deficiencies maintaining their TICL divergences. These anomalies had been cloaked to me by difficult postural compensations, so I did not find them right away. However, when I finally corrected their anatomical deficiencies with proper heel-lifts, they all assumed perfect TICL horizontality and they also stayed that way, too. Of course, I had also used heel-lifts on other patients, but the anatomical deficiencies of these 8 patients had been more cloaked to me.
        Furthermore, I also noticed that patients with diverging TICLs, who were not treated, would gradually over time become perfectly horizontal naturally, unless they still possessed sensory dysfunctions and/or rather large anatomical deficiencies, for which postural balance could not compensate. This is also consistent with natural healing processes, which reduce tissue compressions and swelling. The reduction of swelling will make sensory receptors regain normal function so that the sensory nervous system may rebalance posture optimally with perfect TICL horizontality.
        Note that I write – optimal postural balance with a perfectly horizontal TICL, as any posture may become even more optimally balanced (straighter), as postural balance constantly seeks optimal loading conditions for all postural articulations, including less pain.
        Hypothetically, this is how the body over time produces fewer overloads and less inflammation with swelling and pain. (Also, people simply need to use their bodies accordingly to avoid overloads.)
        Thus, getting rid of sensory dysfunctions and producing perfect TICL horizontality is only half way to the goal, but it certainly is a good start for natural healing processes. Perfect TICL horizontality in all erect humans is simply an optimally balanced posture – not a perfectly balanced and symmetrical posture with the absolutely best loading conditions possible. (Persons with such postures hardly exist.)

        According to the above-mentioned, I should therefore have the right to assume that a perfectly horizontal TICL is a normal and natural condition for all erect humans and that such a condition may be used as a postural frame of reference.

        When discussing normal anatomy and physiology, it is useless to think that 100 % improvements of TICL divergences becoming perfectly horizontal is a 100 % success. Treatments tested with control groups generally concerns immeasurable conditions, and not conditions measureable against a solid frame of reference of physics, like the force of gravity. That is just as meaningless as saying one cannot get 100 % correct results when measuring the normality of the blood CRP-level, which already has a tested procedure. The force of gravity is probably the most persistent physical fact there is and possibly even better than a thoroughly tested blood CRP procedure.

        Reducing neck and back pain concerns insubstantial parts of our physiology, as it concerns both mental and physical dimensions. Of course, evidence-based facts about treatments of pain need to be evaluated with tested procedures like a control group. The success I had when treating musculoskeletal neck and back pain patients may therefore have been tested with a control group, but chiropractic has tried to test pain many times, more or less successfully. However, I have never sought to test the effects of my chiropractic therapy on pain syndromes in this way, as for me, it has been most important to have patients feel the relief of pain whatever it comes from. However, when testing physical facts about chiropractic therapy’s effects on postural balance, I went “outside the box” and found some simple physical facts, which I observed with an anatomical spirit level. And, I told you about my findings, which may be found on https://palmer.academia.edu/JensAndersKjersem
        (Whether you want to believe my findings or not is up to you, but now they are there for you to test them – if you want to.)

        The Academia website contains my papers demonstrating that chiropractic therapy produces improved posture in patients and I do not believe that they say very much about pain. With an anatomical spirit level, I can now prove that chiropractic therapy also produce improved postural balance; in other words, a straighter posture. You may deny it and disown it, but it is still a proven fact against the force of gravity. Additionally, as improved posture reduces poor postural loading conditions, it also logically reduces pain.
        Of course, when discussing pain, there are many aspects to consider, like which type of conditions cause pain, and not least whether or not degenerations, trauma and overloads will cause some or all of the pain, and how surgery may help relieving compression of tissues and reduce pain. Thus, pain is not just about chiropractic therapy and how long one has to wait for the body to naturally heal and reduce overloads through postural compensations, reduce swelling and compression on local nerves so the pain may go away.

        About 30 % of the 896 patients in the 2008 Survey already had a perfectly horizontal TICL; however, they still had neck and back pain, for which they sought chiropractic therapy. From what has been learned from the fact that 70 % of 896 patients with a diverging TICL achieved improved postural balance after chiropractic therapy, it has been only fair to assume that postural balance of those with already perfect TICL horizontality also will continue improving their postural balance further when treated with chiropractic therapy.
        Thus, chiropractic therapy will be able to reduce poor loading conditions and pain in all patients whether they have optimally balanced posture or a posture with diverging TICLs. This is based on the findings showing that those patients who have diverging TICL horizontality assume horizontal TICL perfection after chiropractic therapy. This is not a bad hypothesis, but although it is only a hypothesis, we all know from normal physiology that posture seeks to maintain optimal postural balance against the force of gravity, and that when postural balance is tampered with or altered (mobilized), natural physiological functions seek to neutralize said imbalance of mobilization (tampering/alterations) by balancing posture even further, or once again, against gravity – in a natural way.

        During my many years in practice, there have been many types of “clicky sticks” in chiropractic therapy and they have had varying functions and treatment systems. The TPH or Trigger Point Hammer is just one of them. It is quite easy to put any of them in a category and call them all for “clicky sticks”. I have tested the most well-known “clicky stick” in use today with an anatomical spirit level; this “clicky stick” is called Activator. Although I had a hard time producing measureable postural changes and perfect TICL horizontality with this Activator, I considered that I may not have used it correctly. Although I did not find the Activator efficient in producing improved postural balance (making divergent TICLs perfectly horizontal), there is still a chance that it somehow may correct other nervous functions. However, the “clicky stick” you referred to, called Trigger Point Hammer (TPH) and TriggerCiser (TC), will – on the other hand – produce quite obvious, improved postural changes.

        Also, I have constructed another clinical instrument that I have not told you about. That is I have called, Leg Length Regulator, or for short, LLR. The LLR makes it much simpler and more secure to measure various anatomical deficiencies in patients. The basis for the LLR is that posture is not static and up to about 7 – 9 millimetres, it will instantly compensate for increased leg lengths. Seemingly, these compensations are made by the postural balance in order to maintain perfect TICL horizontality. This is fairly new physiology discovered by me and few chiropractors know about these functions. These functions may very simply be tested and observed instantly with the help of an anatomical spirit level.
        When large anatomical anomalies are present in persons, such anomalies should always be properly corrected in order to reduce poor postural loading causing degenerative reactions. The best and most acceptable way to do that is to measure postural balance on both sides of the body while it instantly compensate for changes in the lengths of the legs. This may be achieved by measuring one lengthened leg against the maximum ability of maintaining perfect TICL horizontality (anatomical frame of reference) on one side first, and then do the same measurement on the other side afterwards. When anatomical deficiencies are present, one leg length (deficiency) is generally more compensated for than the other and by subtracting the measurement of height increase of one leg length from the other measurement of height increase of the other will show a difference of how high a heel-lift ought to be. However, both measurements must be measured equally relative to the postural frame of reference. The side of greatest measurements will always need to be corrected with a heel-lift, which has the height of the calculated difference. Of course, the aforementioned is a very particular science, which needs to be explained and probably demonstrated by me.

        The clinical instrument, the LLR, will only provide height notches of two and a half millimeters at the time. In practice, I found this acceptable, as both sides of the posture are measured. So, if you want to increase the length of a leg with 5 millimetres, the feet support of the LLR must be raised 2 notches on the side of that leg.
        Be sure to know that when heel-lifts are properly administered, the measurements relative to the force of gravity should be equal on both sides.
        Of course, this is important for medical science, too, as medical practice has done this erroneously for years. However, as you and your co-bloggers are behaving like perfect scientists, who know everything, you will probably continue to measure posture and leg lengths statically in spite of actual new physical proofs.

        Sincerely,

        Jens Anders Kjersem, DC
        jensadk@gmail.com
        +47 900 38 545

        • Jens Anders Kjersem,DC: The erect posture (body) adapts to the most ideal weight-bearing positions with a perfectly horizontal TICL. And, if you do not like shortened words, I can write TICL fully, Transvers Iliac Crest Line.

          You really are touching your own Chiropractic Nose here, Jens. That’s probably why, as far as you’re concerned, your chirodigm always seems to “work” for you. Your particular Chiropractic Assertion and guiding chiropractic principle, it seems, is that everyone you diagnose and treat in your office is going to do better, no matter, with a “level” pelvis … as measured IN your office with your chiropractic spinal-dowsing inclinometer. But Ideal Spinal Assertions (ISAs) grounded only in chiropractic say-so are a dime a chiropractic dozen. ALL proprietary Chiropractic Technics are characterized by arbitrary diagnoses with specific therapies directed at “correcting” the specific spinal fiction as explained to the patient in their, ahem … “report of findings.” These fictions, however, are closed loops of chiropractism based on how a body would function if only it was designed by a chiropractor — often a particular chiropractor selling their brand of “chiropractic.”

          Take a look. Who says, “The erect posture (body) adapts to the most ideal weight-bearing positions with a perfectly horizontal TICL”? Why, that’s your assertion, Jens, and not a very good one actually, even if it was true. It might be true, I suppose, if people didn’t move and were pillars holding up a roof. But, your chiropractic inference and belief is that the static “level” pelvis you’ve measured in your office translates into something “ideal” in all possible positions your patient takes when they’re not in your office and going about their lives. How does your ideal level pelvis make your patient more stable or function any better when driving their car or fixing a pipe under the kitchen sink? Or do they have to stand erect in your office for the rest of their lives to achieve the benefits of “Thuh” Adjustment? 🙂

          I’m afraid the fallacy starts (and ends) with your Chiropractic Ideal and the inferences you make when your inclinometer “levels.” Other chirodigms, for example, cite the Atlas and/or Axis as the key to Chiropractic Health. These chiropractors fetishize and argue about the ideal position of a particular bone just as you argue it’s an off-level pelvis that’s the ultimate culprit and Demon of Disease. Other chiropractors are sacral-base freaks. Each of these chiropractors infer “balance” and Chiropractic Health from “level” Atlases and sacral-bases, respectively, as measured on x-ray and/orby checking to see if “the legs even.” Personally and professionally, I’ve tried to encourage chiropractors to “Adjust” T8 — The Most Underrated Vertebra — if they really want to get to the bottom of all this “chiropractic”; but they ALL have their pet vertebrae to sell and serve and won’t hear of it 🙂

          But, spinal function in any particular circumstance or position is rarely, if ever, about standing erect — unless you’re standing at attention in the military. Then you’ve got other problems. By necessity, there’s always a dynamic involving stability, loading, and movement. In case you hadn’t noticed, people move, Jens, and they do things. Measuring — never mind trying to “correct” — the position of any given bone or bones at any given time and bony position is the central chiropractic folly … even if you could change with any permanence a spinal configuration by cracking a joint or joints. That’s a whole other ball of chiropractic wax, which there’s no need to get into without resolving first, “Why a chiropractic duck” to begin with.

          ~TEO.

          • There are a lot of ignorant persons in this world and maintaining the ignorance displayed in the comments against solid undeniable facts does not help any healthcare at all.

            If an erect person is measured to have a perfectly horizontal upper pelvic plane against gravity and you lengthen one of the legs of this person by 5 mm, this erect person will normally still maintain a perfectly horizontal pelvic plane.

            This fact demonstrates what we already know in physiology:

            Posture balances itself by the help of the sensory nervous system and maintains postural balance in any position, not just in erect position. (It is directly stupid to believe anything else.)

            On the other hand, we are now able to measure postural alterations with an anatomical spirit level against a solid control – the force of gravity (a solid frame of reference).

            This spirit level has shown that circa 30 % of all people (896 patients), who have neck and back pain, have perfectly horizontal TICLs. They do not even have a slight divergence of the TICL horizontality, which may be clinically observed with an anatomical spirit level.

            So, ask yourself: Why is this so? (Any fairly intelligent person should understand the answer.)

            I think therefore think that I rest my case for ever with this unserious Edzard Ernst Blog.

          • can you do more than ad hominem?
            can you, for instance, produce evidence?

          • Yes, I can produce physical evidence anytime, but not evidence-based research on paper – rather physical evidence. With any chiropractor using an anatomical spirit level, you may also re-produce such physical evidence by yourself.

            I wrote earlier today:

            “If an erect person is measured to have a perfectly horizontal upper pelvic plane against gravity and you lengthen one of the legs of this person by 5 mm, this erect person will normally still maintain a perfectly horizontal pelvic plane.”

            If you want proof of that you have to make it yourself. The aforementioned concerned a person who generally do not have dysfunctional sensory receptores, but he/she may still have neck and back pain, which will heal even better when postural loads ease further. (Difficult to understand?)

            I write now:

            If an erect person is measured to have a diverging horizontal upper pelvic plane against gravity and you lengthen his/her short leg by 5 mm, this erect person may often still maintain a diverging horizontal pelvic plane. Such a person generally have dysfunctional sensory receptores, but he/she may still have neck and back pain, which certainly will heal better naturally with proper postural loading conditions.

            So, if you care to read what I have written earlier in these comments and also read it with better specificity, you should not have to ask for more research-proof. You may just get it by yourself by using an anatomical spirit level and produce measurements controlled by gravity.

            I am telling you the truth, not according to me, but to what is demonstrated by the spirit level.

          • I am not interested in what you happen to erroneously call ‘evidence’. I need the type of evidence that is internationally accepted to be evidence.

          • So, why did you ask? You know by now that I only have physical evidende to offer to you.
            And, my offer still stands from earlier comments, which is free PAI sent to a local chiropractor. He/she should be able to provide the evidence you may need.

          • I ask because you keep on making claims that clearly are not supported by evidence. don’t you think that it is important to point that out?

          • It is clearly a diffence between evidence-based research and reseach done with physical facts. There we totally agree. I will however try to have other DCs do the same research as I did.

          • Jens Anders Kiersem- This is starting to sound like an article in Viz or ‘Twop Twips’.’.
            Why not just put down the details of your physical evidence on paper?
            Then it becomes ‘physical ‘evidence presented on paper’.
            Simples!

          • Yeah, you are so articulate with your words and have such an understanding it is gripping …

          • This spirit level has shown that circa 30 % of all people (896 patients), who have neck and back pain, have perfectly horizontal TICLs. They do not even have a slight divergence of the TICL horizontality, which may be clinically observed with an anatomical spirit level.

            So, ask yourself: Why is this so? (Any fairly intelligent person should understand the answer.)

            HUH? I don’t even know what you’re talking about … and I’ve been fully trained-in and licensed in “chiropractic” and have taught eager and aspiring chiropractic students in a chiropractic college clinic. So, enough with the I must be unintelligent because I can’t understand what sounds to me like still another pile of chiropractic gobbledygook. I might also note that you didn’t respond to a single thing I wrote by instead offering a repetition of your own chiropractic conclusions — the very definition of touching your own chiropractic nose.

            Moreover, I think, with all this talk of “chiropractic” and chiropractors on Edzard’s blog, I’ve given your proprietary model the time of chiropractic day on its own terms, more than it deserves as far as I can tell, too. PRESUMABLY, you’d want to be the first person to know if you’ve been fooling yourself with your brand of chiropractic subluxation dowsing and your very precise TICL measurements of chiropractic fairies dancing on a Jens Anders Dag Kjersem pin-tip. And really, Doctor, you wouldn’t be the first chiropractor to huff and puff when someone points to your open chiropractic fly and march off indignantly muttering to yourself about “those people who don’t know anything about chiropractic.” My experience is that it’s chiropractors who know the least about what they think, say, and do professionally, relying only on their own chiropractic assertion and say-so that people are Suffering Needlessly when they haven’t had their spines checked and treated by a chiropractor.

            What exactly is your chiropractic goal, Jens? When a person comes to your office with a specific complaint — headache, leg pain, neck pain, shoulder pain, foot pain, let’s say — what do you diagnose and what treatment do you render? For the purposes of this exercise, pretend that these complaints are all of musculoskeletal origin. Is the TICL utilized in all these patients and does a level TICL signify a problem or does it tell you, “My work is done?” It seems you just said, there’s always a level TICL because, as the summation of forces from bottom up and top down, it’s [just] what a body does. So, its meaning to you — never mind its ultimate clinical value — remains, unclear. Why measure it, if it’s always level in a standing person?

            If I’ve misunderstood you and SOME (70%) of symptomatic patients come to you with an “off-level” TICL, is your chiropractic goal then, after whatever treatment you render (which you’re going to tell me about), to have the patient leave your office with a LEVEL TICL — because, you argue, it’s obvious (except to the ignorant critics here) that a patient with a LEVEL TICL is going to “do better” than one with an off-level TICL? If so, what do you tell the many upper cervical and Clinical Biomechanics chiropractors who make this same argument about the Atlas, the PI Ileum freaks, and/or the Gonstead practitioners who tell their patients THEY’re Suffering Needlessly from their proprietary versions of … misalignments?

            Finally, did you know that there are no Chiropractic Misalignments (named Chiropractic Subluxations) that have ever been shown to have any direct bearing on fixing a specific diagnosis (musculoskeletal or not), or even as you assert here, that would make a patient “do better” when they get “adjusted?” … nothing beyond Chiropractic Assurance and say-so, that is. That said, how do you know that you are NOT just another chiropractor in The Great Chiropractic Void who is talking to himself about himself with your TICL? Importantly, isn’t it important to you to know whether or not you’re just repeating the same mistake with each and every patient you treat?

            ~TEO.

          • You said: I don’t even know what you’re talking about … And, I say: You are so correct! Not even as a fully educated trained DC you do not know what I am talking about, as you have not properly read it. At least, the professor seemingly have. So, before you start teaching others, read whats been written. It is new physiology that you never knew about …. teacher, puh. It shows that the professor is correct in many of his criticisms ..

          • Barrie, he still hasn’t answered the first question that was put to him by Sue Ieraci on Wednesday 14 December 2016 at 03:16
            http://edzardernst.com/2016/12/chiropractic-osteopathy-no-thanks/#comment-84285

            Pseudoscience is scratching around in the dirt trying to find a morsel of evidence to support an idea that someone pulled out of their ass, such as Daniel David Palmer. The volume of dirt it kicks up during the process is not surprising. The noise-to-signal ratio of both pseudoscience and anti-science are extremely high, often infinity, for obvious reasons.

          • Sorry, Pete …. that is all for now.

          • Oh dearie me! No true chiropractor, indeed.

          • A true chiropractor seeks to provide better conditions for natural healing; and, I also believe that this is what John has tried to do, too – to the best of his ability and knowledge – even as a teacher for other chiropractors. However, any chiropractor help patients with most articular pain syndromes in a better way than medical doctors, even with their many obvious faults. (Notice that I do not mention the faults of MDs.)

            A chiropractor mobilizes articulations, which he/she believes are dysfunctional (meaning: dysfunctionally locked with poor mobility because tissues are overloaded, inflamed and have become swollen compressing local adjacent tissues). So, when Sue do not accept physical proof showing (physically demonstrating) that chiropractors mobilize affected joints, even when patients are twisted and bent on a treatment bench, we instead have to look at what happens physically in postures after chiropractic treatments. And, that is what I have written on
            the Academia website – https://palmer.academia.edu/JensAndersKjersem (this is what I say on paper).

            The reason for writing my papers on this website, is just to have my findings published publically because they would be rejected as evidence-based research (just ask the professor who is only for such evidence-based research). Because my research is not evidence-based research, it will also be quite poor according to Cochrane and can (will) easily be degraded subjectively by anyone.

            However, physical evidence (proof) is factually even better than than evidence-based research; and, much more secure, as it cannot be tampered with and slyly used to avoid uncertainties. It is undeniable physical proof, which may be reproduced by anyone who wants to do so. Personally, this does not affect me anymore, as I am a none-practicing chiropractor and have no other connections to chiropractic anymore; of course, other than mentally by remembeting all the “ignorant stupid shit” I have faced from MDs in my ethical practice of treating articular pain syndromes for 47 years in practice.

            On this blog, you have used subjective degradations, like saying, “it is true only because you say so”, are quite ridiculous and also meaningless when you want my physical proofs on paper. My proofs may be reproduced by any chiropractor, but your bloggers say they want it on paper? That will never happen, as one cannot put physical effects on paper.

            What has been internationally accepted as proper ways of doing evidence-based research cannot be done with physical proofs. One may therefore cry for proper evidence-based research, but it cannot be put on paper as proof. Therefore, do not say: I do not believe you! Physical effects have to be physically demonstrated. So, other chiropractors have to do it, too. And, it should of course preferably be done by several chiropractors; however, one has to start one time.

            As a chiropractor, I do not need to present said news to ignorant MDs here on this blog. Most MDs are outside our profession and they try to degrade the chiropractic profession almost by any means and for a multitude of reasons, both professionally as well as economic. But, these new physical proofs based on undeniable new physiology need to be demonstrated physically for the Chiropractic Profession, not really for the Medical Profession. So, I even went from Norway to USA and presented this for a research forum at Palmer College of Chiropractic, but what time they will come around to this research simply depends on their funding. That is the reason why I happened to use this forum.

            Even though I see this forum as an unserious, it is still a place for a kind of science entertainment; though, I see that my comments are read too lightly by my colleagues.

          • Jens Anders Kjersem
            I am absolutely stunned now at the poverty of your reasoning.
            Your claim that ‘physical proof(evidence) is better than evidence-based research’ is simply delusional. If there were any such thing as genuine’physical proof(evidence)’, what would then prevent that from being duplicated and then becoming evidence- based research?
            I think I’ll become one of these chiropractors.
            I can tie my own shoelaces, so I reckon I’m half way there as regards qualifications.

          • Sorry Barrie, Your comments speak for themselves. I do not need to answer you.

          • Jens Anders Dag Kjersem
            Cor blimey! That’s me told! And me with my articulate words!
            I feel right miffed and put down, so I do!
            I tip my hat to you and no mistake!
            Anyway I thought you’d gone!

          • @Jens

            “any chiropractor help patients with most articular pain syndromes in a better way than medical doctors, even with their many obvious faults.” OK, where’s the proof for that statement (other than your opinion/experience)?

            “The reason for writing my papers on this website, is just to have my findings published publically because they would be rejected as evidence-based research (just ask the professor who is only for such evidence-based research). Because my research is not evidence-based research, it will also be quite poor according to Cochrane and can (will) easily be degraded subjectively by anyone.” Pleeaase try to recognize why others will see this comment as ridiculous.

            “My proofs may be reproduced by any chiropractor, but your bloggers say they want it on paper? That will never happen, as one cannot put physical effects on paper.” Huh?! So Einstein couldn’t produce a paper proving relativity? Watson & Crick couldn’t write a paper proving the structure of DNA? Marshall & Warren couldn’t write a paper proving Helicobacter pylori resides in the stomach and is associated with peptic ulcer? Surely you are doing exactly the same thing with the articles on your website. What you write down is the evidence, therefore the proof, for your claims. Except — as you admit — you can’t get your work published in peer-reviewed journals because referees reject it.

            “What has been internationally accepted as proper ways of doing evidence-based research cannot be done with physical proofs. One may therefore cry for proper evidence-based research, but it cannot be put on paper as proof.” YES IT CAN! (See previous paragraph: you’re just repeating the same argument.) But your apparent scientific illiteracy is most revealing.

            You come here writing screeds of self-justifying ‘paperwork’, promoting your ideas about your spirit level. And when people point out to you the problems with your hypotheses and ‘proofs’, you simply write them off as ignorant: “As a chiropractor, I do not need to present said news to ignorant MDs here on this blog.” (By the way, I am not an MD, but I presume your tarbrush of “ignorant” extends to mere scientists too.)

            Look, I heard the situation put rather well on a radio programme yesterday. A scientist has to be both a ‘good cop’ and a ‘bad cop’. In ‘good cop’ science mode, you’re open to novel ideas and hypotheses that appear to be plausible based on what we already know and understand. You collect preliminary data to show there may be something you can demonstrate that provides support for your novel ideas. But then you must go into ‘bad cop’ science mode, and carry out experiments well enough designed to prove yourself wrong. If those experiments fail, you’ve gone a long way to proving your novel idea may be true, and publish the detail of your experiments on paper so others can replicate and extend your work.

            That’s the way good science operates. As I’ve said several times elsewhere on this blog, science — done in the way I’ve described above — is merely a tool for probing what’s true and what’s untrue so we can avoid fooling ourselves (I think it was Carl Sagan who first put it this way). By repeatedly rejecting wise counsel in comments on this forum as ‘ignorant’ you are merely demonstrating your own, near messianic belief in your spirit level and its applications. You even denigrate your fellow chiros with your remarks!

            “I even went from Norway to USA and presented this for a research forum at Palmer College of Chiropractic, but what time they will come around to this research simply depends on their funding. That is the reason why I happened to use this forum.” No, it doesn’t simply depend on their funding. The funding excuse for not doing research has been aired and shot down more often on this blog than most altmed rationalizations. In the case of your work you even offer to provide spirit levels free of charge: all that’s required is patients and a tiny bit of extra time. What was the reaction of the people at the Palmer College? If they said they don’t have funding to do the research I suspect they were fobbing you off with excuses. (If your colloquial English is not up to that expression, please Google it.)

            By the way, I don’t think your rants in these comments are doing much good for the general reputation of chiropracxtic or chiropractors.

          • Dear Frank,

            So, my claims is my proofs, you say. Well, that is exactly what I thought, too. So, please test these proofs by yourself instead of making unjust criticism. Even if you are not an MD or you cannot have a local chiropractor test these proofs; you should actually be able to do this by yourself – just because it is so simple.

            My work has factually never been rejected by peer-reviewed journals, as I did something better. I went outside organized peer-reviewed journals and presented my findings directly to Palmer Research Center in Davenport Iowa in 2012, as my findings should be of interest for chiropractic. At this Center, the director understood me quite well and asked many relevant questions while I physically demonstrated the facts. They even had a professor from Palmer Technique Department come over the street to the Center in order to learn. Although this professor clearly understood little or nothing (he was hung on irrelevant details like John), I still tend to believe that your subjective assumption saying that Palmer Research Center was “blowing smoke up my …” is totally incorrect. I could of course have presented my findings in a peer-reviewed journal instead of an official website, but as I am not in “the chiropractic system” anymore, I presented it directly for all chiropractors on https://palmer.academia.edu/JensAndersKjersem
            So, unless you know a better way of presenting my physical evidence (proof) on your blog, said presentation will never take place.

            You mentioned Einstein and a few others; however, they first had to make a hypothesis and a while later (many years later), this hypothesis had to be physically proven to become recognized. Although I compare myself to Einstein (far from), it is still well known that it took about 20 years to get recognition for his hypothesis. So, it is a fact that Einstein’s hypothesis also had to be proven physically before the opposition (guys like you) gave in. However, my case is much simpler and I do not have to wait 20 year for a hypothesis to get recognition, as I already have solid physical facts. These facts have been written down and published on the Academia Website for all of you to see. I have presented my findings as purely as I can on this Website. The presentation carries solid physical facts measured meticulously by me in my clinic over one year (2008) on a rather high number of patients (896). The conclusions I have drawn, may however be regarded as hypothetic, as they are logical assumptions drawn from my findings by me. They you may attack and discuss, but not the fact that about 30 % of 896 patients with articular pain syndromes (mainly neck and back pain) already had a perfect TICL horizontality and that all of the rest (70 %) assumed perfect TICL horizontality after chiropractic therapy.

            One of my first patients getting a spirit level examination came in with a knee problem. I examined him and found that he had a diverging TICL and also tissue inflammation on the medial side of his knee at the meniscus. I therefore mobilized his knee carefully and rather painlessly with a TC (TriggerCiser) at the site of inflammation and instantly he could move better afterwards because he felt much better right away. Although such cases happen a lot in chiropractic clinics, they rarely get an examination of the TICL with an anatomical spirit level. So, I also examined his TICL divergence after the chiropractic TC-therapy and I found that the TICL now had become perfectly horizontal. I was very surprised when this happened that first time and I could not explain what had happened. For most chiropractors, such things keep on happening more or less all the time. However, when 896 of 896 patients get to achieve an absolutely perfect TICL horizontality after therapy, and about 30 % of these already had a perfect TICL horizontality before therapy, then I had to make a hypothesis for what happened:
            My hypothesis is that homeostasis of postural balance in all erect humans seeks to assume perfect TICL horizontality as a part of natural weight-bearing reactions of normal physiology, and that perfect TICL horizontality therefore may be used as a postural frame of reference for those who treat articular pain syndromes affecting postural balance.
            (This does not mean that all pain is healed and gone after a chiropractic treatment, but simply that chiropractors improve loading conditions in posture letting the tissues heal easier and faster.
            Sorry, but that is the factual case whether you, your co-bloggers, chiropractors or other institutions like it or not. You are all twisting and spinning with words, like a fish on a hook not wanting to be landed, but the aforementioned findings are still the case. Luckily, at this stage, some parts are meticulously measured facts while other parts are hypothetical.)

            So, whether my findings get thumbs down from you just because you do not believe that I am telling you the truth, is not really my problem anymore. It is really your own problem when you continue to knock ethical chiropractors. I therefore say, do the tests so facts may be proven or disproven to your own advantage. I do not do research anymore and I do not owe anyone anything. If you want to continue to deny physical facts by saying, “I do not believe you”, it is up to you. But, I still have a few anatomical spirit levels left in my garage and I shall be happy to provide a properly constructed anatomical spirit level to you in case you want one and do not want to make one on your own. In fact, the spirit level that I have left in my garage (PAI) is constructed in a very smart way in order to be easy to use in correct way.

            Be sure of this, I certainly agree with you on one thing; physical evidence is certainly not evidence-based. And, my findings are not screeds of self-justifying paperwork and promotion of ideas of a spirit level – I have no reason for doing that. In fact, when I was working as a chiropractor, I would not even have had the time to communicate with you in this way.

            An anatomical spirit level is a very simple instrument, which physically demonstrates facts about positions of anatomical parts relative to the force of gravity, both before and after therapy. These facts may be denied by you, your co-bloggers and chiropractors over and over again, but the measurements with the spirit level are meticulously done and therefore indisputable. Additionally, they are also irrefutable because they are made on such a high number of patients. So, whether you like it or not, you will finally owe an excuse to all ethical chiropractors for your poor behaviour and bad demeanour against them. Whether they will get this excuse from you in the future is another thing.

            Likewise, I do not think your comments either do any good for the reputation of this blog.

          • Jens Anders Dag Kjersem
            This is now becoming insanely laughable.
            Do you actually mean any of this?

          • Frank Odds,

            Thank you for your excellent detailed reply to Jens.

            As I’ve previously mentioned, one of my very few fields of expertise is test & measurement that is independently audited to be fully traceable to international standards, therefore I know more than most about the importance of your statement “A scientist has to be both a ‘good cop’ and a ‘bad cop'” and your following amplification of this core scientific principle.

            Harriet Hall, MD, coined the expression “Tooth Fairy science”: doing research on a phenomenon before establishing that the phenomenon exists.
            http://www.skepdic.com/toothfairyscience.html

            You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is reproducible and statistically significant. Yes, you have learned something. But you haven’t learned what you think you’ve learned, because you haven’t bothered to establish whether the Tooth Fairy really exists.

          • One gets the feeling one is wasting one’s time. My previous succinct comment still stands.

  • Ree-SULT!
    Illogical Bias admitted me to the Drones Club!
    Although since he seems to have developed a strange obsession recently with male masturbation I”m having second thoughts about accepting.
    What do you think, people?

  • Dear Barrie Lee ‘Wellness’ Thorpe:

    I am sorry that you feel “miffed and put down”, even though I have been trying holding myself back with my comments. Conceivably, I have been too rough on you, regardless of character attacks against me, half-truths, almost-truths, and paradigms like internationally accepted evidence-based proof (great statistical research). However, soon, you will be rid of me, as I will be gone on travel for many weeks in Asia (remember: I am a pensioner now).

    Dear Frank Odds,

    (Quote from his comments 🙂 “By the way, I do not think your rants in these comments are doing much good for the general reputation of chiropractic or chiropractors.”
    (I am of course glad that you have empathy and worry about the general reputation of chiropractic or chiropractors, but since this blog usually demeans chiropractic and chiropractors as much as possible, I get a feeling that you just appear to have concern for this reputation.)

    However, I will my give comments to you here (probably my last before I leave for Asia):

    It is great that you have noticed that I aim to make too open comments and that I make them openly whether they are good for chiropractic or not. I have tried to write about my findings in a very truthful way all the time. In my 47 year of practice, I have empirically learned that truth usually prevails sooner or later. Therefore, I expect that you, your co-bloggers, MDs, DCs, physicists and Chiropractic Institutions will not escape this truth either. All the facts I have found and have published are true. I know that, so I stick to the truth whatever you say, even against your shaking heads and “good-meaning” advices. Why should I not when I factually know that my facts are true?
    On the other hand, if you are able to prove that my facts are wrong, I shall also go with this truth and certainly be the first one to bow and say “excuse me” (I believe that is more than you will do to me.) Till now, you and your co-bloggers have only asked for evidence-based research proving my facts and you also say it is up to me to prove these fact. Conversely, I say, “They must be demonstrated physically with a spirit level”. So, if chiropractors and chiropractic cannot stand up for what is truthful and right, including the rants of my comments, so be it. THAT is exactly how I feel.

    In reality, I have not conveyed so many of my personal thoughts/experiences to you, but I can tell you this much: The Director of Palmer Research Center was a very intelligent person, but he is not a DC. So, on his own accord, he contacted Palmer Technique Department across Brady Street in Davenport, Iowa in order for me to demonstrate the amazing true immediate effects of human physiology with the use of an anatomical spirit level (PAI). I had already demonstrated these for him. He clearly expected that my demonstration should both amaze and revolutionize thinking of all the professors in the Technique Department at Palmer CC. However, he, I and the rest of the employees at the Research Center only met a cold shoulder from the Professor of the Technique Department. Said Professor had little interest in learning new physiology, and neither had anyone at Palmer Technique Department.
    (I will describe said Technique Professor to be just as hung up on irrelevant details as Dr. John Badanes, whose comments you read previously showing that he did not understand that normal physiology balances postural articulations by autonomy according to the sensory nervous system and the force of gravity – not according to the directions of an adjustment. This may easily be demonstrated with a spirit level.)

    To make a better understanding for you and your co-bloggers about of the situation at Palmer College of Chiropractic in Davenport, Iowa, I will make five questions to which you know the answers:

    1. Did the both the Director of the Research Center and I believe that Palmer Technique Department would change their points of view on chiropractic right away when they got said facts physically demonstrated? Or, did we expect that the Technique Department needed some time to let it sink in?

    2. Did both of us really believe that the outmost superior institution of chiropractic – the home of chiropractic, which now is in the second century of teaching chiropractic – should stop teaching what it has taught as of outmost importance: Specific Directional Adjustments of Bones?
    (Just google “Cox Technique” or “Gonstead Technique” to understand a few of the most important techniques taught at Palmer CC and you will understand that such information will take a long to it to sink in – both in teaching schedules and economically.)

    3. Did we really believe that by a simple demonstration, the University of Palmer CC should start teaching my very new information, which they have never heard about; and, which said that the body naturally produces its own postural balance through the sensory nervous system – in spite of adjustment directions?
    And, do chiropractors have to adjust an iliac bone very specifically with a proper directional technique learned at Palmer CC when these bones become perfectly level by autonomy?

    4. Should I therefore be afraid of supplying information showing/demonstrating that an iliac bone really does not have to be adjusted at all in order for the upper pelvic crests to become perfectly level – just because natural postural balancing functions do this automatically according to gravity – no matter what – even simply by TC-adjusting of a knee problem with a percussion hammer?

    5. So, does a dysfunctional iliac bone have to be adjusted in a specific direction in order to have the upper iliac crests assume perfect TICL horizontality? No, such an adjustment should simply just mobilize the affected sacroiliac joint carefully and not necessarily in a specific direction, as natural autonomic postural balancing functions do this no matter what! And, empirically, chiropractors are good at mobilizing affected joints – probably the best, but THAT is according to my empirical but subjective view of things.

    John Badanes said he was a teacher in a chiropractic institution and that he taught eager students what he believed was correct. After a while, he has also seemingly understood (from what he wanted to teach me in his comments) that many of the various beliefs in chiropractic were totally wrong. However, whichever techniques he taught, these students when becoming DCs would in general trigger natural autonomic postural balancing responses, producing less pain – thereby make happy patients. Thus, the students he taught to practice ethically would in general also get great results from treating musculoskeletal pain syndromes due to the natural autonomic postural balancing functions of normal physiology. (An anatomical spirit level shows these physiological reactions immediately as facts every time on all patients.)

    So, now you may possibly understand why I still maintain these facts found in 896 patients in 2008 and why I do not worry about the rants of my comments causing poor reputation in general for chiropractic or chiropractors.

    With all the various chiropractic techniques (and there are many hundreds of them working empirically well), even the Gonstead technique and Palmer diversified technique that I used in my own practice in my first almost 40 years, chiropractors with all their various techniques simply and only trigger tissue sensory functions producing natural postural balancing reactions in total posture. However, as these seemingly improve loading conditions against all weight-bearing articulations, but they become especially efficient as treatment of articulations related to poor postural loading conditions because these autonomic reactions reduce poor loads and pain in said affected postural articulations – especially in the neck and the back. However, there may be other functions in chiropractic, which is not discussed here. I simply tell you what has been uncloaked by me. And, notice that I am not talking about those rather few chiropractors who treat medical condition they should stay away from.

    Well, do I need to say any more?
    Please, just read what I have published on the Academia Website, https://palmer.academia.edu/JensAndersKjersem and I will be gone forever.

    • Jens wrote on Friday 23 December 2016 at 09:14:

      Sorry! I saw it too late that the comments that I answered were not for me. I guess I am too old for this kind of blogging and will remove myself from further participations. …

      Well, do I need to say any more?

    • Anybody else make sense of this? Buggered if can. I don’t remember that I made any attacks on the feller’s character, just his daft arguments and claims. Still, if that’s what he says.
      I just hope he enjoys his time in Asia, though Dog knows what silly ideas he’ll bring back.

    • Still, I hope Jens has a good time.in Asia. think he might have taken objection to being called a ‘loony’, perhaps not realising that this word in English, although seemingly aggressve, , can be meant quite kindly. Though, that said, he.’s obviously a loony. But I still wish him well in Asia. May he come back with new wisdoms with which to enthralli is.

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