A CBP® Instructor, Researcher, and Clinician’s Rebuttal to Allen Botnick, DC

Introduction

Near the end of 2003, an article appeared on the Quack Watch website critiquing the Chiropractic Biophysics Technique (CBP®) protocols, procedures and research publications. In my opinion, this web site masquerades as a scientific source for public protection. In my opinion, this site’s primary agenda is discrediting legitimate aspects of Complimentary and Alternative Medicine treatment approaches for patients suffering a variety of health conditions. To this end several non-allopathic (standard medical) treatment interventions have been criticized under the guise of science and public awareness. After reading the critique of the CBP® technique written by an Allen Botnick, DC, it was my opinion that his critique was full of fabrications, misrepresentations, and total one sided non-scientific arguments without proper scientific support.

Recently, one of my patients was referred to the CBP® Technique website, www.idealspine.com, for extra information on this highly supported chiropractic technique. Following this patient’s visit to our website, she desired further information and performed a google search on the CBP® Technique. She accessed and read the Quack Watch article written by Allen Botnick, DC. After reading this article, my patient was concerned and confused over what she had read regarding the technique my office utilized on her; which by the way dramatically helped her chronic pain conditions. This patient asked me if I could account for and properly rebut the criticisms offered by Allen Botnick, DC. I explained to her that I already had and promptly printed out a copy of the following article.

Because of my experience above, I decided to make this available to all CBP® Technique practitioners and patients. Please read the following and make an informed decision regarding the agenda and accuracy of this Quack Watch Critique of CBP® Technique.

The Source of the Quack Watch CBP® Critique:

The individual who wrote the Quack Watch article is Allen Botnick, DC. As always one should look at the credibility of the individual writing a critique and their qualifications as an expert in the respective field that the critique involves. To this effect, I found ZERO Index Medicus citations for Allen Botnick, DC on Pub Med. Allen Botnick, DC has never authored an appropriate literature review/critique in the scientific literature. Furthermore, Allen Botnick, DC has never sat on an expert panel, does not sit nor review for any scientific journals, and has never (to my knowledge) presented at a scientific conference on Chiropractic Sciences. Therefore, in my opinion, I conclude that Allen Botnick, DC is not an authority/expert in the Chiropractic sciences and techniques.

In contrast, I’m a formal researcher in the chiropractic sciences and educator for continuing education seminars for Chiropractors. As such, when I read Allen Botnick’s article on CBP® Technique, I was able to immediately spot misrepresentations, non-scientific supported arguments, and outright fabrications concerning his claims and references of such. I will provide rebuttal by analyzing his references and claims based on these, I will provide the known scientific research rebuttals as published by CBP® Technique, and then I will end with gross inaccuracies made throughout Allen Botnick’s article.

A) One might believe that Allen Botnick, DC used proper scientific references to support his critiques of CBP® Technique, however, the original report that was posted on Nov 24, 2003 contained 36 references (this has been altered now for unknown reasons?). Of these 36 references, 24/36 (including the two from the Drs. Peet) are actual CBP® published references that were written by CBP® authors and thus do not support any of Dr. Botnick’s claims of the reliability and validity concerns with CBP® technique.

B) Therefore, this leaves Allen Botnick, DC 12/36 references that might possibly support his criticisms. Of these 12 references, 3 of them have to do with orthotics, which have nothing to do with the reliability and validity of CBP® technique. In fact, in their seminars, Drs. Harrison (founders of CBP® Technique) discuss the use of orthotics and a short leg analysis with heel/shoe lifts (see Drop Table Adjusting Seminar outline on www.idealspine.com). Drs. Harrison have always taught that pelvic lateral translations and pelvic y-axis rotations cause foot pronation/supination problems and eversion/inversion problems.

In my clinic (Ruby Mt. Chiropractic), we routinely recommend orthotics for patients in need. Further, I utilize the Zebris Force Plate to analyze 3-Dimensional stress concentrations on the surface of the foot during static stance and dynamic gait to help decide upon the necessity of orthotics. This equipment is very sophisticated and is likely much more advanced than what Allen Botnick, DC, might use to analyze foot abnormalities. This was blatantly portrayed in the opposite manner in a whole paragraph, which appears fabricated by Allen Botnick, DC concerning some “deformed heel” story. Since there is no reference for such a statement/story, I conclude that this is a fabrication by Allen Botnick, DC in an attempt to make me and CBP® Technique look bad.

C) This leaves Allen Botnick, DC with 9 references of which 3 are from Non Scientific Journals (#34 is a telephone conversation, #30 is an Internet Chat room debate, #26 is the CRJ from Life and is not a index medicus scientific journal). These are not appropriate peer reviewed sources and are primarily personal opinions. It is interesting that one of these references is an “internet chat room” debate for which Allen Botnick references (#30 in his original Quack Watch article) Gary Knutson, DC as a Chiropractic Researcher and refers to him as an assumed authority figure.

I did a Medline on Gary Knutson, DC and found approximately 9-11 publications of which none were in Journals outside Chiropractic and none were critiques of CBP® Technique. While Gary Knutson DC should be complimented on his few research accomplishments, in my opinion, 9-11 publications hardly qualifies Gary Knutson, DC as an authority figure in Chiropractic. More importantly, Botnick’s reference to Gary Knutson, DC based on his “opinion” is a known fallacious argument in scientific evidence called the fallacy of Appeal to Authority.1 Why does Botnick reference “internet chat rooms” instead of proper scientific evidence? Why doesn’t Gary Knutson, DC write a formal letter to the editor in a scientific journal critiquing the CBP® work instead of side-stepping proper scientific forum? This leaves Allen Botnick, DC with only 6 credible references.

D) Of these 6 remaining references, 1 is from Petersen et al (JMPT 1999) on Facet Hyperplasia. Most DCs are obviously not aware that at the WFC May 2003 conference, I (Dr. Deed Harrison) presented a platform manuscript with 252 subjects (5 times more subjects than Petersen et al.) and found no correlation between facet angles, heights, shape of the dens and cervical lordosis.2 This manuscript was later published in the journal Clinical Anatomy3 (a high quality Anatomy journal put out by the Mayo Clinic). Since Allen Botnick, DC is not a formal chiropractic researcher, he likely did not attend the WFC conference research presentations where this manuscript was presented. Furthermore, he likely does not read Clinical Anatomy and seems to have ignored this rebuttal work by CBP®. Nevertheless, ignorance is not an excuse and in my opinion he has bias against the Harrison’s and CBP® Technique.

1. Stein F. Anatomy of Research in Allied Health. New York: John Wiley & Sons. 1976, pg 45.

2. Harrison DE, Harrison DD, Haas JW, Janik T, Holland B. Do sagittal plane anatomical variations (hyperplasia) of the cervical facets and C2 odontoid affect the geometrical configuration of the cervical lordosis? Results of digitizing lateral cervical radiographs in 252 neck pain patients. Presented at WFC 7th Biennial Congress, Orlando, FL. May 2003.

3. Harrison DE, Haas JW, Harrison DD, Janik TJ, Holland B. Do Sagittal Plane Anatomical Variations (Angulations) of the Cervical Facets and C2 Odontoid Affect the Geometrical Configuration of the Cervical Lordosis? Results from Digitizing Lateral Cervical Radiographs in 252 neck pain subjects. Clin Anat 2005; 18:104-111.

E) This leaves 5 references possibly supporting Allen Botnick, DC. One of these is Haas et al JMPT 1999. Of interest, this article is the middle reference of a 3-part debate between CBP® researchers and Haas et al.

I wonder why does Allen Botnick, DC discuss one of these (Haas et al) without the other two papers published by me and CBP®?4,5 In their May 1999, Haas et al wrote a rebuttal to a CBP® manuscript that appeared in May 1998 JMPT.4 Later in Dec 2000,5 the CBP® research team rebutted this Haas et al article with more than 6 times the scientific supporting references provided by Haas et al. The truth of the matter is that “in a blistering rebuttal”, We AT CBP® destroyed the Haas et al. arguments. Again, in my opinion, Allen Botnick, DC shows his ignorance of the literature and bias against CBP® Technique by his lack of providing both sides of this debate.

4.Harrison DE, Harrison DD, Troyanovich SJ. Reliability of Spinal Displacement Analysis on Plane X-rays: A Review of Commonly Accepted Facts and Fallacies with Implications for Chiropractic Education and Technique. J Manipulative Physiol Ther 1998; 21(4):252-66.

5.Harrison DE, Harrison DD, Troyanovich SJ. A Normal Spinal Position, Its Time to Accept the Evidence. J Manipulative Physiol Ther 2000; 23: 623-644.

F) This leaves 4 references for Allen Botnick, DC. One of these is a patient hand book or guide book for which Botnick claims there is proof that CBP® traction causes patients to have neck pain. I read this hand book and found absolutely no evidence provided for the incidence or prevalence of such claimed iatrogenic injury to patients. The only evidence I found was the personal opinion of the author (Homola). Again, this is not evidence this is pseudo-scientific evidence at best.

By way of comparison, the known morbidity and mortality rates for cervical spine surgery for cervical myelopathy can reach 2% for death rates (mortality) and 8% for complication rates (morbidity).6 The reader will note that I cited proper scientific sources for this not an opinionated hand book as Allen Botnick did. Perhaps Quack Watch would be better suited informing the public of known injury rates such as these instead of fabricated claims out of a non-scientific, non-peer-reviewed patient hand book.

Additionally, out of this same “Patient Hand Book” by Homola, Botnick claims that CBP® extension traction is a likely cause of stroke. Personally, I find this to be a serious breach of ethics and scientific documentation as evidence suggests that there is no known position of the cervical spine that has been specifically linked to stroke. In a 1999 review of the literature on varying positions of the head associated with vertebral and basilar artery blood flow and dissection, Haldeman7 concluded, “examination of the data fails to show a consistent position or movement of the neck that could be considered particularly dangerous”. In addition, Thiel8 found no occlusion of vertebral artery blood flow during various head and neck positioning tests on the patient, including head extension.

Lastly, just to be sure, I searched the scientific literature for studies possibly linking CBP® treatment to patient injury. I could not locate a single case report in the literature linking CBP® extension traction to stroke or to other injury. Stroke is a serious concern. However, for Dr. Botnick to make a statement that extension traction causes stroke without any data other than Homola’s (a non expert in stroke injuries) personal opinion (out of a patient handbook), is a serious breach of scientific ethics and evidence citing. Since Allen Botnick, DC has never authored a legitimate scientific study, he likely is not aware that this type of evidence would never be allowed in a scientific journal or debate (again ignorance is no excuse). But for Dr. Barrett, Quack Watch director, to allow this type of breach in scientific evidence, points to a probably bias against the Harrison’s and CBP® Technique.

Based on the above facts, it is my opinion that there is an agenda here to make CBP® Technique look bad. Instead of challenging them in the appropriate scientific forum (peer reviewed index-medicus journals) Dr. Barrett and Allen Botnick, DC have elected a forum for which there is no recourse other than Dr. Barrett’s. My perspective is that Dr. Barrett and Botnick and the like would lose a formal debate with CBP® Researchers if forced to follow the scientific etiquette of peer-reviewed journals.

6. Fouyas IP, Statham PFX, Sandercock PAG. Cochrane review on the role of surgery in cervical spondylotic radiculomyelopathy. Spine 2002;27:736-747.

7. Haldeman S, Kohlbeck FJ, McGragor M. Risk factors and precipitating neck movements causing vertebrobasilar artery dissection after trauma and spinal manipulation. Spine 1999;24:785-794.

8. Thiel H, Wallace K, Donat J, Yong-Hing K. Effect of various head and neck positions on vertebral artery blood flow. Clin Biomech 1994;9:105-110.

G) This leaves Allen Botnick, DC with 3 references for which all are authored by Dr. Gore in Spine. Importantly and again, Allen Botnick completely ignored the work that I and CBP® researchers have published in rebuttal to Dr. Gore’s work. For example, I previously wrote a letter to the editor on Gore’s 2001 Spine manuscript.9 These articles have also been critiqued by me and others in CBP®’s Cervical Rehab text (2001 Chapter 3) and in two CBP® published scientific manuscripts.10,11

Concerning this debate, Gore et al. (Spine 1986) found an incidence of 9% of segmental kyphosis in 200 asymptomatic subjects and found no subjects to have a complete kyphosis from C2-C7. Compared to the data from Gore et al. in asymptomatic subjects, McAviney and Myself10 studied 277 patients (many with straight and kyphotic cervical curves) and found that these abnormal neck curves are 18 times more likely to present with neck pain and headache symptoms. This10 data strongly suggests that abnormal neck curves (kyphosis) are risk factors for neck pain. Additionally, Hardacker et al.12 and Harrison et al.13 demonstrated that segmental kyphosis is a significant risk factor for neck pain as it occurs 35%-39% of the time in symptomatic subject populations compared to 9% in asymptomatic populations (Gore). Several other high quality studies, with various pain groups matched to controls, have identified differences in the cervical lordosis.14-20 Again, these studies were intentionally ignored by Botnick.

It is my opinion that Dr. Botnick (and Dr. Knutson in his ‘chat room’ debate) purposely did a selective literature review on this topic. According to the information provided here, Botnick and Knutson have twisted the evidence in their favor and bias against the Harrison’s CBP® Technique is evident.

9. Harrison DE, Bula J. Response to Gore D. [Roentgenographic findings in the cervical spine in asymptomatic persons: A 10-year follow-up. Spine 2001;26:2463-6] Spine 2002;27:1249.
10. McAviney J, Schulz D, Richard Bock R, Harrison DE, Holland B. Determining a clinical normal value for cervical lordosis. J Manipulative Physiol Ther 2005;28:187-193.
11. Harrison DD, Harrison DE, Janik TJ, Cailliet R, Haas JW, Ferrantelli J, Holland B. Modeling of the Sagittal Cervical Spine as a Method to Discriminate Hypo-Lordosis: Results of Elliptical and Circular Modeling in 72 Asymptomatic Subjects, 52 Acute Neck Pain Subjects, and 70 Chronic Neck Pain Subjects. Spine 2004; 29:2485-2492.
12. Harrison DD, Harrison DLJ. Pathological stress formations on the anterior vertebral body in the cervicals. In: Suh CH, ed. The proceedings of the 14th annual biomechanics conference on the spine. Mechanical Engineering Dept., Univ. of Colorado, 1983:31-50.
13. Hardacker JW, Shuford RF, Capicotto PN, Pryor PW. Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms. Spine 1997; 22:1472-80. Hohl M. Soft-tissue injuries of the neck in automobile accidents. J Bone and Joint Surgery 1974;56-A:1675-1682.
14. Zatzkin HR, Kveton FW. Evalutaiton of the cervical spine in whiplash injuries. Radiology 1960;75:577-583.
15. Kristjansson E, et al. Is the Sagittal configuration of the cervical spine changed in women with chronic whiplash syndrome? A comparative computer-assisted radiographic assessment. JMPT 2002;25:550-555.
16. Norris SH, Watt I. The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone and Joint Surgery 1983;65-B:608-611.
17. Kai Y, et al. Neurogenic thoracic outlet syndrome in whiplash injury. J Spinal Disorders 2001;14:487-493.
18. Nagasawa A, et al. Roentgenographic findings of the cervical spine in tension-type headache. Headache 1993;33:90-95.
19. Katsuura A, et al. Anterior cervical plate used in degenerative disease can maintain cervical lordosis. J Spinal Disorders 1996;9:470-476.
20 . Kawakami M, Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disorders 1999;12:50-56.

Items Ignored by Allen Botnick, DC & Gross Inaccuracies/Fabrications:

Now that I have thoroughly analyzed and rebutted Allen Botnick DC’s references used to support his proposed criticisms of CBP® Technique, I will shift my rebuttal to show that Allen Botnick, DC has selective ignored a large quantity of CBP® published studies and presents Gross inaccuracies/fabrications in a purposeful attempt to discredit CBP® Technique.

H) CBP® Technique has published 6 Clinical Control Trials validating the treatment frequency, duration, and patient outcomes of care.21-26 These 6 published clinical control trials demonstrate that CBP® treatment methods (mirror image adjustments, exercise, and traction) combined with short term spinal manipulation can improve spinal alignment in the AP view and improve the cervical and lumbar lordotic curves. Additionally, these trials show that a CBP® 10-12 week, 36 visit program of care will reduce the intensity of chronic pain in the cervical and lumbar regions in patient populations. Lastly, 3 of these studies (22-24) have long-term patient follow-ups demonstrating that spinal corrections are maintained and that patient pains remain improved after CBP® care. See:

21. Harrison DD, Jackson BL, Troyanovich SJ, Robertson GA, DeGeorge D, Barker WF. The Efficacy of Cervical Extension-Compression Traction Combined with Diversified Manipulation and Drop Table Adjustments in the Rehabilitation of Cervical Lordosis. A Pilot Study. J Manipulative Physiol Ther 1994;17(7):454-464.
22. Harrison DE, Cailliet R, Harrison DD, Janik TJ, Holland B. New 3-Point Bending Traction Method of Restoring Cervical Lordosis Combined with Cervical Manipulation: Non-randomized Clinical Control Trial. Arch Phys Med Rehab 2002; 83(4):447-453.
23. Harrison DE, Harrison DD, Cailliet R, Janik TJ, Holland B. Changes in Sagittal Lumbar Configuration with a New Method of Extension Traction and its Clinical Significance. Arch Phys Med Rehab 2002; 83(11): 1585-1591.
24. Harrison DE, Harrison DD, Betz J, Janik TJ, Holland B, Colloca C. Increasing the Cervical Lordosis with CBP® Seated Combined Extension-Compression and Transverse Load Cervical Traction with Cervical Manipulation: Non-randomized Clinical Control Trial. J Manipulative Physiol Ther 2003; 26(3): 139-151.
25. Harrison DE, Harrison DD, Haas JW, Betz JW, Janik TJ, Holland B. Conservative Methods to Correct Lateral Translations of the Head: A Non-randomized Clinical Control Trial. J Rehab Res Devel 2004;41(4):631-640.
26. Harrison DE, Cailliet R, Betz JW, Harrison DD, Haas JW, Janik TJ, Holland B. Harrison Mirror Image Methods for Correcting Trunk List: A Non-randomized Clinical Control Trial. Eur Spine J 2005; 14:155-162.

Few other Chiropractic Techniques have published Clinical Control Trials. While Clinical Control Trials are very time consuming and difficult to do, CBP® is doing these studies. Allen Botnick, DC made many untrue statements while not discussing the clinical outcome studies published by CBP®. The only missing studies are randomized clinical trials (RCT’s) documenting which aspects of CBP® treatment is responsible for the majority of pain, function, and health improvements. Research is a step by step process.

However, until such time that RCT’s are performed on CBP® technique, there is strong evidence in the form of well designed Case Reports that CBP® Technique treatment methods are superior to standard care (spinal manipulation and other typical treatments) for several chronic conditions. In these studies, CBP® Technique postural and spinal rehabilitation showed dramatic improvements in pain, ROM, disability scales, and health status (depending upon the study).27-33 Importantly, it is known today that well-done case studies (such as CBP®’s) most often demonstrate findings consistent with that of the RCT.34,35

27. Harrison DE, Bula JB. Non-operative correction of flat back using lumbar extension traction: A case study of three. J Chiropractic Education 2002;16(1). In review at the JMPT 2005.
28. Paulk GP, Bennett DL, Harrison DE. Management of a chronic lumbar disk herniation with CBP® methods following failed chiropractic manipulative intervention. J Manipulative Physiol Ther 2004; 27(9): 579e1-579e7.
29. Bastecki A, Harrison DE, Haas JW. ADHD: A CBP® case study. J Manipulative Physiol Ther 2004; 27(8): 525e1-525e5.
30. Ferrantelli JR, Harrison DE, Harrison DD, Steward D. Conservative management of previously unresponsive whiplash associated disorders with CBP® methods: a case report. J Manipulative Physiol Ther 2005; In Press for March.
31. Haas JW, Harrison DE, Harrison DD, Bymers B. Reduction of symptoms in a patient with syringomyelia, cluster headaches, and cervical kyphosis. J Manipulative Physiol Ther 2005; In Press.
32. Berry RH, Oakley PA, Harrison DE. A structural approach to the postsurgical laminectomy case. J Chiropractic Education 2005;19(1):44.
33. Oakley PA, Harrison DE. Use of Clinical Biomechanics of Posture (CBP®) protocol in a postsurgical C4-C7 total fusion patient. A case study. J Chiropractic Education 2005;19(1):66.
34. Venning GR. Validity of anecdotal reports of suspected adverse drug reactions: The problem of false alarms. BMJ 1982;284:249-252.
35. Benson K, Hartz AJ. A comparison of observational studies and randomized controlled trials. N Engl J Med 2000;342:1878-1886.

I) Allen Botnick, DC took several liberties with short summaries of different topics from the CBP® web site (idealspine.com). The majority of these were written by former Life University students who were learning CBP® Technique and wanted to help Dr. Joe Ferrantelli contribute to the website. Allen Botnick, DC claims that Drs. Deed Harrison and Don Harrison made these statements when in fact the Harrison’s’ did not author these (Botnick’s references #1,3,13-15,). If one read for the content of these summaries, one would notice that Allen Botnick’s summaries from those summaries are quite misleading. Lastly, once we found out that this information was on there and written by chiropractic students, we promptly asked Dr. Joe Ferrantelli to remove this area and he agreed as he did not actually check it for detailed content.

J) In another instance, Allen Botnick, DC fabricated quotes from Dr. Don Harrison. For example, Allen Botnick, DC claims that Dr. Don Harrison stated that 50% of patients discontinue CBP® treatment because of pain. After communication with Dr. Don Harrison (my father) and my own experience with CBP® Technique and seminars, I know that this is a fabrication by Allen Botnick, DC. In my opinion, this statement is a type of slander and is libelous. As per Allen Botnick’s own clinical mishap story, my opinion is this shows his incompetence as a clinician and is likely why he is rumored to have failed in private practice. The statement made by Botnick has no place in a true scientific debate/critique as it is hearsay and only supported by a non-credible source (Botnick himself) with an agenda of purposefully making CBP® Technique look bad. In my opinion, Dr. Barrett has the same agenda as he published this type of ridiculous evidence on Quack Watch.

K) To continue, Allen Botnick, DC stated “However, instead of criticizing chiropractic openly, Harrison created and marketed a technique that he alleged would correct these errors and improve outcomes,…” This is a grossly inaccurate statement and exactly opposite the truth. CBP® Technique (Harrison’s) have published numerous critical literature reviews, performed original studies, and have openly challenged traditional chiropractic systems.36-48 For Botnick to assert otherwise, only attests to his ignorance of CBP® publications in the peer-reviewed literature. Furthermore, I and Dr. Don Harrison attend multiple scientific conferences (WFC, RAC, ISSLS) and have sat on scientific panels where we “openly criticize chiropractic”.

36. Harrison DD, Colloca CJ, Troyanovich SJ, Harrison DE. Torque: An Appraisal of Misuse of Terminology in Chiropractic Literature and Technique. J Manipulative Physiol Ther 1996; 19(7):454-462.
37. Harrison DD, Harrison DE, Troyanovich SJ, Hansen D. The Anterior-posterior Full-spine View: The Worst Radiographic View for Determination of Mechanics of the Spine. Chiropr Tech 1996;8(4):163-170.
38. Harrison DE, Harrison DD, Troyanovich SJ. The Sacroiliac Joint: A Review of Anatomy and Mechanics. J Manipulative Physiol Ther 1997; 20(9): 607-617.
39. Harrison DE, Harrison DD, Troyanovich SJ. Three-Dimensional Spinal Coupling Mechanics. Part I: A Review of the Literature. J Manipulative Physiol Ther 1998;21(2): 101-113.
40. Harrison DE, Harrison DD, Troyanovich SJ. Three-Dimensional Spinal Coupling Mechanics. Part II: Implications for Chiropractic Theories and Practice. J Manipulative Physiol Ther 1998; 21(3): 177-86.
41. Troyanovich SJ, Harrison DD, Harrison DE. A Review of the Validity, Reliability, and Clinical Effectiveness of Chiropractic Methods Employed to Restore or Rehabilitate Cervical Lordosis. Chiropr Tech 1998; 10(1): 1-7.
42. Coleman RR, Bernard BB, Harrison DE. The Effects of Real Life X-axis Vertebral Translation on Projected Y-axis Vertebral Rotation Images. J Manipulative Physiol Ther 1998; 21:333-340.
43. Troyanovich SJ, Harrison DD, Harrison DE. Motion Palpation: It’s Time to Accept the Evidence. J Manip Physiol Ther 1998; 21:568-571.
44. Harrison DD, Colloca CJ, Troyanovich SJ, Harrison DE. Torque Misuse Revisited. J Manipulative Physiol Ther 1998; 21: 649-655.
45. Coleman RR, Bernard BB, Harrison DE. Measurements of 2-D Projected Images of 3-D Vertebral Rotation on the Y-axis. J Manipulative Physiol Ther 1999;22(1):21-25.
46. Coleman RR, Harrison DE, Fischer T, Harrison SO. Correlation and Quantification of Relative 2-D Projected Vertebral Endplate Z-axis Rotations with 3-D Y-axis Vertebral Rotations. J Manipulative Physiol Ther 2000; 23: 414-419.
47. Harrison DE, Harrison DD, Janik TJ, Holland B, Siskin L. Slight Head Nodding: Does it reverse the cervical curve? Eur Spine J 2001; 10: 149-153.
48. Coleman RR, Harrison DE, Fischer T. The effects of combined x-axis translations and y-axis rotations on projected lamina junction offset. J Manipulative Physiol Ther 2001;24(8): 509-513.

L) Allen Botnick, DC takes shots at the CBP® Normal Spinal Model and at the claims that alterations in the curves of the spine are linked to early degenerative joint disease (DJD). Botnick alludes to the posters on spinal decay. However, Allen Botnick, DC does not offer any references to the contrary in this section. Only his non expert opinion is provided. A close look at these posters will elucidate that DJD is only shown in the military, segmental kyphosis, and complete kyphotic spines.

According to the science of biomechanics detailing spinal loads, stresses, and strains, abnormal neck and low back curvatures (kyphosis) are indeed documented causes of spinal arthritis and disc disease. Multiple studies have identified that x-ray line drawing is able to determine that straightened, segmental kyphosis, and complete reversals of the sagittal curves are linked to premature degenerative joint disease.49-58 Of course to understand the mechanism one would need to have extensive knowledge of loads and stress generated potentials (Wolff’s Law) and it is my opinion that Allen Botnick, DC does not have formal training in the field of Biomechanics.

49. Harrison DE, Harrison DD, Janik TJ, Jones EW, Cailliet R, Normand M. Comparison of axial and flexural stresses in lordosis and three buckled configurations of the cervical spine. Clinical Biomechanics 2001;16:276-284.
50. Matsunaga S, et al. Significance of occipitoaxial angle in subaxial lesion after occipitocervical fusion. Spine 2001;26:161-165.
51. Katsuura A, et al. Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels. Eur Spine J 2001;10:320-324.
52. Matsunaga S, et al. Biomechanical analysis of buckling alignment of the cervical spine. Predictive value for subaxial subluxation after occipitocervical fusion. Spine 1997;22: 765-771.
53. Borden AGB, Rechtman AM, Gershon-Cohen J. The normal cervical lordosis. Radiology 1960;74:806-810.
54. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 2001;10:314-319.
55. Oda I, et al. Does spinal kyphotic deformity influence the biomechanical characteristics of the adjacent motion segments? An in vivo animal model. Spine 1999;24:2139-2146.
56. Umehara S, et al. The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine 2000;25:1617-1624.
57. Akamaru T, et al. Adjacent segment motion after a simulated lumbar fusion in different sagittal alignments. A biomechanical analysis. Spine 2003;28:14:1560-1566.
58. Hohl M. Soft-tissue injuries of the neck in automobile accidents. J Bone and Joint Surgery 1974;56-A:1675-1682.

M) Continuing to make false statements about the CBP® Normal Spinal Model, Botnick asserts, “CBP® analysis does not appear to consider underlying causes of postural problems such as pregnancy, obesity, torn ligaments, foot pronation, muscle shortening, and malformation of vertebra.”

In complete contrast to Botnick’s statement, these issues have been addressed by CBP®. For examples,

1) concerning pregnancy, CBP® has published in the peer-reviewed literature59 and in their technique text book60 the CBP® approach to managing the pregnant patient. For Allen Botnick, DC to state otherwise is entirely inaccurate.

2) Concerning obesity or body mass index (BMI), in their spinal biomechanics text, Harrison, Harrison and Haas,61 present an updated elliptical model of the thoracic and lumbar sagittal curvatures. Here, the lumbar elliptical minor/major axis ratio (b/a) was shown to be .32 compared to their earlier study of .39.62 Part of the reason for the difference in the b/a ratio is due to several overweight subjects in their previous manuscript.62 Thus, CBP® has shown that increasing BMI causes a more circular lumbar lordosis. Therefore, I assert that CBP® is well aware of this issue and it is Allen Botnick’s ignorance of CBP® research and his own lack of understanding that causes him to fabricate these statements.

3) The foot pronation idea has already been addressed under item B above.

4) The muscle shortening statement is complete conjecture made up by Botnick and the torn ligament notion would be detected in an appropriate x-ray analysis that most of us DC’s (including CBP®’ers) learn in Chiropractic college.

5) The malformation of vertebra statement has been addressed under item D and blocked vertebral anomalies have been addressed by Harrison, Harrison, and Haas in the CBP® Cervical Rehab Book, Chapter 3.63

Aside from true wedge shaped scoliotic vertebra, I could locate Zero support for Allen Botnick’s statements. For suggested support of his conjectures, Allen Botnick, DC refers to Haas et al., but Haas et al. presented no data to support that spinous process asymmetry causes known changes in spinal alignment. In fact, these statements by Haas et al were rebutted by me and CBP® researchers previously.5 Instead of offering his rampant personal opinions and opinion papers by others how about some real evidence. Where’s your data Botnick?

59. Troyanovich SJ. Chiropractic approach to exercise for the pregnant patient. Chiropr Tech 1993;5(2):56-59.
60. Harrison DD. CBP®â Technique: The Physics of Spinal Correction. National Library of Medicine #WE 725 4318C, 1982-97.
61. Harrison DE, Harrison DD, Haas JW. Spinal Biomechanics for Clinicians. Volume 1. Harrison CBP® Seminars, Inc., Evanston, WY. 2003; page 41.
62. Harrison DD, Cailliet R, Janik TJ, Troyanovich SJ, Harrison DE. Elliptical Modeling of the Sagittal Lumbar Lordosis and Segmental Rotation Angles as a Method to Discriminate Between Normal and Low Back Pain Subjects. J Spinal Disord 1998;11(5):430-439.
63. Harrison DE, Harrison DD, Haas JW. CBP®, Structural Rehabilitation of the Cervical Spine. Harrison CBP® Seminars, Inc., Evanston, WY. 2002; page 62.

N) Dr. Botnick claims that “CBP®’s inclusion in chiropractic curriculums violates the Council on Chiropractic’s Education’s standards…” I suggest that this statement could have legal ramifications not only by CBP® Technique but also by the colleges that offer CBP® as an elective and core curriculum as part of Chiropractic Education. Allen Botnick, DC only offers his opinion, he does not represent the CCE’s position on this matter, and does not sit on any board that approves such techniques in chiropractic college curricula. Thus he carries no authority to make this statement. In my opinion, only a vindictive and biased individual would make these types of statements without facts and proper citations.

Conclusions

Allen Botnick DC’s, criticisms of CBP® technique are not supported by legitimate scientific evidence. Only his personal opinion and those opinions of a few fringe Chiropractors are provided to claim CBP® Technique has reliability and validity concerns. In fact, Allen Botnick has not brought forth any information that CBP® Researchers have not already addressed through their scientific publications and text books. The non-discriminate reader (in particular an unwary patient) is left with the opinions of a fringe chiropractor. Allen Botnick, DC has never published a single scientific manuscript in the peer-reviewed literature, has never participated in an expert panel for guidelines, and does not sit on any board nor does he review for a single scientific journal. In short, no credible scientist would give him a second look or listen—so why should I: Because of the extreme confusion that he has created for CBP® Patients and outright fabrications he has made in a public forum.

While Chiropractic has continued to combat public image problems, I wonder why a DC, would be associated with long time Chiropractic critic, Dr. Barrett, MD? And for Dr. Barrett to allow an article of this poor quality to be written by a Chiropractor (Allen Botnick) with no scientific authority/caliber is very suspect. Dr. Barrett has given his forum to and helped create an “Internet Expert” in the Chiropractic profession. Try doing an actual author search in the scientific literature on Allen Botnick, DC and you will find emptiness.
Lastly, after reading my rebuttal, if Dr. Barrett is an honest person and a true “scientist”, he will remove the unsupported CBP® attack by Allen Botnick, DC from his web site.

In the name of science,
Deed E. Harrison, DC
President, Chiropractic BioPhysics Technique and Seminars

Diversified Adjustment Techniques are Necessary in Delivering Spinal Relief

Like a handyman with his trusty toolbox, chiropractors have their own set of methodological tools. The theory for both professions is the same: every problem requires a unique and tailored approach to yield results. A handyman doesn’t hammer in a nail with a screwdriver and a chiropractor doesn’t use drop table adjustments when they should use traction.

Diversified adjustment techniques are critical in delivering tailored relief to patients with spinal misalignments. Understanding the approach is just as important as administering the treatment, which makes the ability to thoroughly vet a condition paramount. This is where Chiropractic BioPhysics (CBP) stands apart. It ensures the proper adjustment method is applied to a specific situation.

CBP-trained chiropractors utilize their full suite of adjustment techniques on a case-by-case basis. This ensures patients receive the very best care possible for their unique condition.

The chiropractor’s toolbox

Chiropractic adjustment and manipulation of the spine falls into a general category of rehabilitation known as high-velocity, low-amplitude (HVLA) technique. As the name implies, the method of affecting change through physical manipulation is done via sudden, precise intervention with low levels of force.

But HVLA is just the metaphorical toolbox of a chiropractor. Within this distinction, there are numerous specific modalities that are used to adjust patients based on their condition. And though they all share the same characteristics, the way they’re administered makes them unique. Some examples include:

  • Drop technique: Adjustment via this technique is done by creating space and momentum. Patients lay on a special table with specific sections that, when triggered by the chiropractor, release. This allows areas of the patient to drop simultaneously as they’re being acted upon, facilitating the adjustment.
  • Diversified technique: This is the classic method of adjustment. Patients usually sit or stand while a chiropractor positions joints for movement. With a quick thrust and shift, the affected area is pushed back into the bounds of normal range of motion. In some cases, the body is positioned in an overcompensating way to facilitate a more determined shift.
  • Gonstead technique: This hybrid HVLA adjustment uses supports to induce joint movement during adjustment. Instead of creating a void, as a drop table might, Gonstead technique creates resistance that helps to facilitate movement. The positioning of the patient has roots in the diversified technique.
  • Traction: Traction is an outlier in HVLA adjustment because it’s often static in its application. The patient is placed in traction and held there to decompress or train the body to correct itself. Nevertheless, traction is a chiropractic tool that’s frequently employed in tandem with other HVLA adjustments.

Pairing method with condition

When patient conditions are diagnosed via CBP, an adjustment plan is next to follow. Based on the nature of the diagnosis, the proper adjustment techniques must also be chosen. This means a chiropractor must thoroughly assess the patient and the adjustment methodology on a case-by-case basis. Doing so can help to produce quantifiable results when the condition is revisited later in the CBP recovery timeline.

The CBP approach and its extensive toolbox of chiropractic adjustment methods help CBP-trained chiropractic professionals assist patients with a wide range of spinal issues. Pairing clinical assessment with practical adjustment techniques paves the way for results that are truly tailored to the individual.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Chronic Fatigue May Have Roots in Your Cervical Spine

Thyroid conditions are among the most under-explored ailments plaguing Americans today. They range from minor (under-active thyroid) to major (thyroid cancer), and have a profound impact on everyday life regardless of severity.

The reason thyroid conditions are often overlooked is because their symptoms are general. Fatigue, moodiness, muscle pain, brain fog, and more are all cornerstones of a thyroid condition. Consequently, these same symptoms can be indicative of numerous other conditions. Attributing them to thyroid dysfunction specifically means delving deeper into the body’s physiology. Often, this means examining the spine.

Assessing the spine from a Chiropractic BioPhysics (CBP) standpoint helps to solidify a thyroid diagnosis by examining the cervical spine of patients complaining of general fatigue. Exploring subluxations in the lower cervical spine can yield insight into potential nerve blockages and other contributing factors to thyroid conditions.

Roots in C7

The nerve cluster linked to the thyroid gland can be mapped down the spine to the last cervical vertebrae: C7. This is the first place a chiropractor will examine when patients have complaints of fatigue, brain fog, or moodiness. Subluxations, translation, or disc deterioration at the C7 vertebrae could mean the nerves and blood supply to the thyroid are being disrupted or cut off entirely.

Linking cervical dysfunction

Subluxations in C7 are not an absolute cause of thyroid dysfunction. This single vertebra may not show signs of movement at all, which means a chiropractor may have to probe further into the cervical spine for evidence of a thyroid condition.

Looking for chiropractic issues that correlate with thyroid troubles means examining and linking spine conditions with possible ailments. For example, cervical dysfunction patients may see general nerve issues emanating from this region, which may be contributor to faulty nerve signals being delivered to the thyroid gland. Diagnosis of a root condition that has peripheral effects on the gland is another way of helping to qualify a thyroid condition.

Patient history

Does hyper- or hypothyroidism run in a patient’s family? Is the patient under immense stress from work or in their personal life? Are there other symptoms worth noting about a patient’s wellness that align with thyroid function? These details are necessary in linking nerve disruption to thyroid ailments and factoring the potential role spinal manipulation could have in alleviating symptoms.

Treating cervical misalignment

Piecing together evidence of subluxations, blocked nerves, cervical spine dysfunction, and patient details can form a complex picture of a thyroid condition. And, even if that condition is being tested or treated by a general physician, it may still benefit from chiropractic adjustment.

While general physicians may recommend diet and medication to correct thyroid function, chiropractors can help to improve the nerve function to the gland itself. This may include re-opening pinched pathways, restoring blood flow to the region, or helping nerve signals fire appropriately and fully.

At Ideal Spine, we advocate for an incremental, tailored approach to restoring cervical spine curvature and nerve health. Our team has seen numerous patients who complain of fatigue, mental fog, and moodiness, and we’ve helped many of them link these symptoms to thyroid dysfunction. If you constantly feel like you’re in a fog, schedule a free consultation with us today to learn more about our through Chiropractic BioPhysics (CBP) approach.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Dissecting Contributors to Cervical Dysfunction Through CBP Analysis

Cervical dysfunction is a condition characterized by pain, stiffness, and muscle spasms in the neck. It’s a very limiting condition that can come and go seemingly at random, making it hard to diagnose and treat effectively. Many patients are even fooled into never seeking treatment, finding credence in the “wait until it gets better” method.

What causes cervical dysfunction to rear its ugly head is the subject of much debate, and there’s little concrete evidence to suggest one factor over another. Some chiropractors believe premature wear of cervical facet joints is the catalyst for dysfunction, while others contribute whiplash-like trauma to its formation. Muddled origins further serve to make diagnosis difficult, which complicates treatment for patients who genuinely have the condition.

Chiropractors trained in Chiropractic BioPhysics (CBP) take a calculated approach to diagnosing cervical dysfunction. This enables them to deliver a diagnosis that both characterizes the condition and exposes its contributing factors.

Visualizing dysfunction

Diagnosing cervical dysfunction is often hard because of its generalized symptoms – pain, tightness, stress, tension, etc. Without exploring further, general chiropractic can misdiagnose the condition. For a truly reliable and accurate diagnosis, x-rays are required. This is where CBP has the upper hand.

Radiological imaging is built directly into the CBP approach, giving chiropractors visible, tangible findings to work with in forming a diagnosis. For an erratic condition like cervical dysfunction, being able to see eroded facet joints or bulging cervical discs means ruling out common misdiagnoses in favor of a correct one.

Pinpointing contributing factors

Reviewing x-rays and collaborating with a physical assessment enables chiropractors to compile contributing factors to dysfunction. In addition to scientific findings, CBP also relies on the anecdotal accounts of patients, which can yield important information. When combined with patient history, the complete CBP process can provide unique insight into the development and persistence of cervical dysfunction:

  • Radiological images that show subluxations or degeneration;
  • Physical assessment with abnormal findings, such as disc translation;
  • Visual observation of things like poor postural tendencies or habits;
  • Anecdotal accounts of recent trauma such as untreated whiplash;
  • Clinical findings of previous surgeries or genetic predispositions.

With a full picture of a patient’s spine health – including emphasis on the cervical spine – a chiropractor using the CBP approach can begin to make accurate assertions about the catalyst(s) of cervical dysfunction.

Treating cervical dysfunction

CBP does more than identify the causes of dysfunction, it also creates the blueprint for resolving them individually. For example, if subluxation and recent trauma are contributors, a CBP treatment plan may include an adjustment schedule and physiotherapeutic remedies for mobilization. If facet joint degeneration and poor posture trigger dysfunction, the tailored plan may focus on teaching proper posture and decompression therapy.

In knowing the factors, causes, and contributors to cervical dysfunction, chiropractors can better assess them at a more precise level, affecting positive change at the macro (whole body) level.

Explore the gamut of options

Understanding pain is the key to resolving it, especially in complicated situations like those involving cervical dysfunction. If not treated directly, the pain can continue to dictate the way you live your life and the quality by which you live it.

Chiropractors adhering to the sequential and thorough guidelines of CBP are able to better diagnose ailments like cervical dysfunction, enabling them to treat causes and contributors to the condition better.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Understanding Biomechanics of the Neck: How Heavy is Your Head?

Though it’s the most condensed segment of spine, the cervical spine is of special importance. It’s where Atlas (C1) is located – the gateway that connects your central nervous system to the rest of your spine. It’s also where major nerve bundles reside, such as those corresponding to your eyes, ears, thyroid, and general mental faculties.

These reasons and more are why a simple condition like kyphosis is so dangerous. It’s why the team at Ideal Spine works so hard to educate patients on the importance of adopting good posture. Maintaining proper biomechanical structure of the neck is the key to avoiding a mess of problems originating from cervical spine disruption.

Posture is at the center of problems

When the cervical spine loses proper curvature and deviates from a neutral center of gravity, widespread disruption occurs for all of the nerve bundles residing in this region. Beyond pinched and compressed nerves, kyphosis can also disrupt the biomechanics of the neck, putting immense stress and strain on the soft tissue of the region. Finally, there’s the supported muscle groups of the neck, shoulders and chest to consider.

All of this relates to posture. Spending excess time hunched over looking down at a smartphone or with your head turned slightly to one side staring at a computer screen are two common examples of daily, negative posture. They reinforce deviation from a proper, supportive curvature and force your body to adapt to support the weight of your head. The results are seen in kyphosis-related conditions such as bulging discs, pinched nerves, and general pain.

Understanding biomechanics

Biomechanics are important because they help chiropractors understand where deviation from support has occurred and to what degree it’s affecting your health. For example, let’s take a look at how kyphosis can affect the neck as it supports the head:

  • Normal: The human head weighs about 12lbs normally. At a normal curvature, the cervical spine is designed to support this weight. There is no excess stress being placed on the spine or surrounding muscles.
  • 2-inch deviation: If the head is moved 2 inches forward on the Z-axis, approximately 20lbs of weight can be added to the head due to the lack of support against gravity. This means the head now has a force of 32lbs and the neck is strained to nearly 3x its normal to offer support.
  • 3-inch deviation: Add one more inch of forward movement and the gravitational pull of the head becomes 42lbs. The neck is thoroughly strained at this point, with a dangerous curvature that disrupts nerve pathways and stresses vertebral discs.

Kyphosis is truly a condition of inches – even millimeters when you consider the awesome force of gravity and its ability to quickly exacerbate the condition.

Biophysical relief

Understanding biomechanics is only the first step in treating kyphosis and posture-related cervical spine conditions. To apply treatment in a targeted manner, treatment must be formulated with biomechanics in mind. This is the foundation of Chiropractic BioPhysics (CBP).

Through CBP, every adjustment made and every cervical spine condition assessed is done thoroughly and with a quantitative eye. Focus is on restoring proper biomechanical structure to the spine and paving the way for kyphosis suffers to live better lives.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Improving Your Back Posture With Chiropractic BioPhysics®

Mirror Image® Methods Improves Chronic Low Back Pain by 73%

In one of the longest follow up surveys to date, Kaaria et al[4] reported on the initial, 5, 10, and 28 year low back pain prevalence and incidence in a population of Finish metal workers. Initially, 54% of the cohort reported low back pain (LBP) and 25% reported radiation into the lower extremity (LEP). In the group with LBP, 75%, 73%, and 88% reported pain at 5, 10, and 28 year follow-up respectively. In the group with LEP, 66%, 65%, and 69% reported pain at 5, 10, and 28 year follow-up respectively. Thus, LBP and LEP are not self-limiting conditions that remit on their own over time; the prognosis (outcomes of treatment) for chronic LBP is less than favorable.

Recently, a breakthrough non-randomized trial looking at a new treatment for chronic low back pain sufferers was performed and published by researchers from Chiropractic BioPhysics Technique or CBP Nonprofit. [1]

The study was performed on subjects with chronic low back pain and abnormal lateral trunk shift posture. Treatment methods including Chiropractic BioPhysics® or CBP® Technique Mirror Image® posture exercises, posture adjustments, and posture traction. In the treated group, the mirror image interventions (exercise, adjustments, traction) were applied 3x per week for 12 weeks and resulted in a 73% improvement in chronic low back pain intensity and 50% improvement in the abnormal trunk translation posture and frontal view x-ray lumbar spine displacements. [1] See figure.

3632

The treatment group was compared to a control group who were told to ‘self-manage’ their chronic LBP as they had prior to the start of the study. The outcomes of the control group were strongly in contrast to the treatment group where: 1) control subjects chronic back pain remained unchanged over the course of the study, 2) the control subjects trunk translation posture was found to statistically worsen over the course of the study. [1]

Thus, mirror image® methods (lateral translation exercise and traction) were found to produce statistically significant and clinically significant reductions in pain and trunk translation posture, a finding not observed in the control group. In fact, the control group’s lateral thoracic translations were slightly worse at follow-up, possibly indicating progression of the disorder. [1]

How Can You Get Help for Chronic Low Back Pain?

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Reference Links

  1. Harrison DE, Cailliet R, Betz JW, Harrison DD, Haas JW, Janik TJ, Holland B. Harrison Mirror Image Methods for Correcting Trunk List: A Non-randomized Clinical Control Trial. Euro Spine J 2005; 14(2):155-162. (Link)
  2. Croft PR, Macfarlane GJ, Papag eorgiou AC, Thomas E, Silman AJ. Outcome of low back pain in general practice: a prospective study. BMJ 1998; 316:1356–9.
  3. Enthoven P, Ska rgren, Oberg B. Clincial course in patients seeking primary care for back or neck pain: A prospective 5-year follow-up of outcome and helath care consumption with subgroup analysis. Spine 2004; 29:2458-2465.
  4. Kaaria S, Luukkonen R, Riihimaki H, Kirjonen J, Leino-Arjas P. Persistence of low back pain reporting among a cohort of employees in a metal corporation: A study with 5-,10-, and 28-year follow-ups. Pain 2006; 120:131-137.

Patient Perspectives: Does Back Pain Affect My Overall Health?

Many chronic back pain and neck pain sufferers have reported that their condition has led to a wide range of physical, psychological, and emotional problems. From headaches, migraines, and digestive issues, to depression, anxiety, fatigue, and compromised immune systems.1-3

Does Back Pain Effect Your Health?

Yes. Recent studies clearly indicate that alterations in alignment of the sagittal plane (side view) of the spine are strong determinants of back pain, disability, and health status; this is especially true for the lumbo-pelvic region of the spine.4-6 For example, in a 2002 report, Korovesis et al4 prospectively evaluated the lumbar lordosis (side curvature) in 100 normal controls age, sex, weight, and occupation matched to 100 Chronic LBP subjects between the ages of 20-70 years. In addition, to radiographic alignment, all subjects completed the SF-36 Health Status Questionnaire. It was found that chronic LBP statistically correlated to general health, physical function, emotional function, social function and pain. Importantly, all these variables were also statistically correlated to a reduced overall lumbar lordosis, a reduced L4-S1 lordosis, and a reduced L4-S1 lumbar disc height index.

It’s not just your bones, muscles, ligaments, and discs that feel the effects of spinal misalignment; your nervous system will be affected too. The nervous system is responsible for EVERY function of the human body. The brain sends vital nerve energy down into the spine, and out to all the limbs and organs – effortlessly and without any interference. The reality is that when people’s spines have been misaligned one way or another, this altered alignment exerts excessive and sometimes, dangerous, pressure on the delicate nerves flowing out of the spine.

Generically, altered nervous system pressures from spinal misalignment can be thought of as nerve interference. This interference not only causes pain and discomfort in the back and neck, but more importantly cuts down on vital nerve energy from reaching other body systems. Without proper nerve energy, body systems may experience dysfunction and eventually disease may set in.

Surgery vs. Conservative Care?

While severe spine deformities can require surgical interventions, why not fix the problem before it gets to that point. As early as 2002, studies demonstrated that very focused conservative-non-surgical methods can improve the sagittal plane alignment in patients with low back pain and disability.7-10 One of the most successful non-surgical methods for restoration of the lumbar lordosis and pelvic tilt is called extension lumbar traction; this was developed and tested by Chiropractic BioPhysics or CBP Technique researchers.7 More than a decade later, other researchers have confirmed what Chiropractic BioPhysics researchers reported and suggested in 2002 – that correction of the lumbar side view of the spine improves back pain, disability, and nerve function.8-10

How Does Spinal Misalignment Happen?

Spinal misalignment is a result of poor postural habits (computer use, driving, watching TV), automobile accidents, sports injuries, and even birth trauma. Everyone who experiences gravity, will eventually experience some sort of spinal misalignment. Back pain, neck pain, and headaches are often the last indications of spinal misalignment, since the majority of internal organs don’t have many pain receptors and can’t signal that something is wrong. Fatigue, depression, anxiety, fibromyalgia, acid reflux disease, asthma, high blood pressure, allergies, weak immune system, and difficulty sleeping are all common indications that there can be a serious spinal misalignment.

What Can Be Done to Remedy This?

One of the best ways to eliminate the source of pain, dysfunction, and disease is to realign the spine back to its correct shape, and take pressure off of the delicate nerves in the neck and back.

Chiropractic BioPhysics® or CBP Technique is one of the most researched, scientific, and results-oriented corrective care techniques in the world. Chiropractors who practice CBP have seen tremendous results with patients suffering with chronic back and neck pain, disease, and in many cases, even organ dysfunction.

How Can You Get Help?

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.

Reference Links
1. http://www.ncbi.nlm.nih.gov/pubmed/25322735
2. http://www.ncbi.nlm.nih.gov/pubmed/25006368
3. http://www.ncbi.nlm.nih.gov/pubmed/15583360
4. http://www.ncbi.nlm.nih.gov/pubmed/12394662
5. http://www.ncbi.nlm.nih.gov/pubmed/25274788
6. http://www.ncbi.nlm.nih.gov/pubmed/23722572
7. http://www.ncbi.nlm.nih.gov/pubmed/12422330
8. http://www.ncbi.nlm.nih.gov/pubmed/23640324
9. http://www.ncbi.nlm.nih.gov/pubmed/22632584
10. http://www.ncbi.nlm.nih.gov/pubmed/22684211

Your Neck Curvature Will Help You or HURT YOU if You’re Involved in a Car Crash

Lordosis Protects from Whiplash

Unfortunately, many people can relate to having been involved in a car crash or motor vehicle collision (MVC) at some point in their lives. Whether it was a major accident or a minor one, MVC’s are no fun and can cause a variety of minor to serious injuries to those persons in the vehicles. These injuries are commonly and collectively referred to as ‘Whiplash Injuries’. The financial implications of a MVC, as well as interruption of your daily routine due to whiplash are also other major detriments of car crashes that may take years to recover from.

With more distracted drivers texting and speaking on their phones, MVC’s are on the rise, making for much more dangerous roadways. While we cannot control other people’s behaviors, we can certainly drive more cautiously and defensively to hopefully avoid being in a car accident. Unfortunately, MVC’s do happen despite our best efforts, so being prepared and having a plan in mind is key to recovering quickly and getting back on our feet again.
Cervical Lordosis Boise ChiropractorMore serious car accidents mean more serious injuries, ranging from cuts and bruise to broken bones, brain damage, and even death. At first, less serious MVC’s however, may not seem like a big deal, with victims often walking away without a scratch, believing they have escaped the crash unscathed. Others may only complain of a slight headache, neck pain, stiff or kinked neck while resorting to taking over the counter pain killers, or wearing a neck brace to assist with their recovery – something that is far from addressing the true cause of the injury.

What most lay people (and even many physicians) don’t realize is the extent to which the CERVICAL LORDOIS (curvature in your neck from the side) plays a role in both: 1) the extent of the initial injury to the occupant(s) and 2) the long term pain and suffering from whiplash injury to the occupants. Furthermore, the MVC itself will damage the cervical lordosis.

1. Concerning the extent of initial injury, researchers have found that having a well preserved cervical lordosis actually prevents neck tissue damage to the sensitive cervical spine ligaments.1 In the figure at the top, the right hand image demonstrates what a normal cervical curve looks like when viewed from the side and the person facing to the right. In contrast, the same researchers identified that straightened cervical curves and worse yet, reversed (kyphotic) cervical curves predisposed to more severe cervical spine tissue injuries due to more extreme forces acting on the neck during the exact same MVC circumstances. The x-rays above at the far left and the middle show abnormal neck curves where more severe injury to the person is likely to result should they be involved in an MVC.

Thus, if you already have an abnormal cervical curvature prior to any MVC, it is in your best interest to rehabilitate the shape and amount of your cervical lordosis. If you do not, you’re at a higher risk of having more serious injuries should you be involved in a MVC.1

2. In terms of long term pain and suffering, several research studies have identified that the patients who experience long term whiplash injuries and suffering are in fact the ones that have abnormal cervical lordosis. Straightened, S-curves, and Reversed cervical curvatures have been found to pre-dispose to the following conditions after MVC:2-6

• Neck pain and stiffness,
• Headaches,
• Arm pain,
• Thoracic outlet symptoms,
• Dizziness,
• Lack of concentration,
• Degenerative arthritis in the cervical spine,
• Disc herinations.

What many whiplash injured subjects don’t realize is that a slight headache or neck pain is a true sign of a much more serious injury to your cervical lordosis and underlying neck tissues. Spinal misalignments as a result of the sudden jolt of the MVC may manifest immediately, or not become evident at all for a long period of time. But this doesn’t mean the spine is healthy or that no injury was sustained.

The fact is that MVC’s statistically damage the shape of your cervical lordosis. Researchers from Chiropractic BioPhysics have identified that the average patient exposed to a MVC will lose 10 degrees of their cervical lordosis, develop a mid cervical kyphosis, and have increased forward head posture as a result of the MVC.7

A misaligned cervical curvature as a result of a MVC is a serious health condition. Altered cervical curves will cause nerve interference – hindrance of critical nerve energy that is responsible for every function of our organs, and every movement of our limbs. Ignoring the cervical spinal misalignment can manifest into pain and discomfort, fatigue, sleep disorders, organ dysfunction, depression, and eventually disease.

What Can You Do to Improve Your Cervical Lordosis?

Improving Cervical LordosisIf you have been in a minor or major car accident, please see a corrective care chiropractor immediately for a full assessment of the health of your spine, even if you don’t feel any discomfort whatsoever. A small misalignment can only get worse with time, so addressing this injury quickly can mean a faster recovery time and less health problems in the future.

Corrective methods using Chiropractic BioPhysics® or CBP® Technique extension traction procedures and devices are the only true evidence based methods that have been shown to statistically and clinically improve the amount of cervical lordosis without the use of surgery. This has been documented in several clinical trials and case reports.8-11 Other conservative methods may restore the cervical lordosis in selected cases, but these have never been proven in clinical trials and are thus, at best, hit and miss. If you are suffering from an altered cervical lordosis as a result of a MVC, use the procedures that are truly scientifically supported.

[hr]
References and links to the pubmed research articles:
1 Stemper et al. Journal of Biomechanics 2005: http://www.ncbi.nlm.nih.gov/pubmed/15863116
2 Kai et al. Journal of Spinal Disorders 2001: http://www.ncbi.nlm.nih.gov/pubmed/?term=Kai+Journal+of+Spinal+Disorders
3 Hohl M. Journal of bone and Joint Surgery Am. 1974: http://www.ncbi.nlm.nih.gov/pubmed/4434036
4 Norris SH and Watt I. Journal of Bone and Joint Surgery 1983: http://www.ncbi.nlm.nih.gov/pubmed/6643566
5 Giuliano V. Emergency Radiology 2002: http://www.ncbi.nlm.nih.gov/pubmed/15290548
6 Kristjansson E, et al. JMPT 2002: http://www.ncbi.nlm.nih.gov/pubmed/?term=Kristjansson+E+Journal+of+Manipulative+and+Physiological+Therapeutics
7 Harrison DE, Katz E. Abnormal static sagittal cervical curvatures following motor vehicle collisions: Literature review, original data, and conservative management strategies. Proceedings of the International Whiplash Trauma Congress 2006; Portland, OR, June 2-3, pages 24-25.
8 Harrison DD et al. JMPT 1994: http://www.ncbi.nlm.nih.gov/pubmed/7989879
9 Harrison DE et al. Archives of Physical Medicine and Rehabilitation 2002 http://www.ncbi.nlm.nih.gov/pubmed/11932844
10 Harrison DE et al. JMPT 2003 http://www.ncbi.nlm.nih.gov/pubmed/12704306
11 Ferrantelli JR, et al. JMPT 2005: http://www.ncbi.nlm.nih.gov/pubmed/15855899
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Chiropractic Care and Acid Reflux Disease / GERD

Gastroesophageal Reflux Disease (GERD / Acid Reflux Disease), is becoming more and more prevalent throughout the world, especially among middle-aged and the older segment of the population. However, even pediatric populations are developing GERD signs and symptoms at an alarming rate. Ignoring GERD symptoms or failing to eliminate the cause, can lead to ulcers and esophageal cancer.

While diet, smoking, stress, caffeine intake, and certain drugs all contribute to GERD, recent studies suggest that lumbar kyphosis – or the abnormal curvature of the spine – combined with back muscle weakness, can have a “significant effect” on the presence of the disease. Furthermore, increased thoracic–mid back- curvature called hyper-kyphosis has also been found to cause and / or contribute to the signs and symptoms of GERD. There are at least two mechanisms whereby altered spinal and postural alignment can lead to GERD.

First is a direct mechanical effect. Lumbar kyphosis and thoracic hyper-kyphosis will increase the pressure placed on the stomach and esophageal system; in some cases the pressure is so severe, it will cause a displacement of the stomach downward leading to a condition known as hiatal hernia. Furthermore, the altered spinal-posture alignment will cause inhibition of the stomach-gastric muscle reflex activity that is critically important for digestion and transportation of food from the stomach to the intestines. In the end, this complex reaction caused by altered spinal alignment is what leads to GERD in many cases.

Second is a direct and indirect neurological effect. Further compounding the mechanical causation of GERD is the fact that slight, moderate, and severe spinal abnormalities and misalignments in the spine will put unnecessary and often detrimental amounts of pressure on the delicate nerves coming out of the spine. Since the nervous system is responsible for EVERY function of the human body, including movement of our limbs and the function of our vital organs, it should be apparent that altered and inhibited nerve activity – as a result of poor posture– can also lead to disturbances of stomach function. Chiropractors call altered nerve function from altered spinal alignment “Nerve Interference”.

Nerve interference can diminish the amount of vital nerve energy reaching the organs, including the stomach. If left untreated, the stomach and digestive tract will go into a state of dysfunction, and eventually disease. Many GERD sufferers under the care of corrective care chiropractors have reported significant reduction in their symptoms. That’s because realigning the spine back to its healthy shape and strengthening the back muscles reduces the mechanical pressure on the internal organs and allows nerve energy to flow freely throughout the body; therefore restoring normal function to the stomach and other vital organs.

Chiropractic BioPhysics® or CBP® Technique is one of the most researched, scientific, and results-oriented corrective care techniques. It aims to realign the spine back to health, eliminate nerve interference, and return the body to a state of health and wellness.

If you or a loved one is suffering with GERD / Acid Reflux Disease contact a CBP Certified or trained Chiropractor in your area to get help. No matter how many bland diets you go on, lifestyle changes you make, or proton pump inhibitors you take, the source of the disease and dysfunction may not necessarily go away, unless your spinal misalignments are addressed and corrected.

Contact our team of Chiropractic BioPhysics experts at http://www.idealspine.com/cbp-patient/ and learn more about how Chiropractic BioPhysics (CBP) can help you realign your spine and eliminate the root cause of Acid Reflux Disease / GERD for good.

Supporting scientific references.

  1. http://www.ncbi.nlm.nih.gov/pubmed/22370926
  2. http://www.ncbi.nlm.nih.gov/pubmed/18949531
  3. http://www.ncbi.nlm.nih.gov/pubmed/23476890
  4. http://www.ncbi.nlm.nih.gov/pubmed/21878734

Curtis Fedorchuk DC and Andrew St. Bernard DC. Improvement in Gastro Esophageal Reflux Disease Following Chiropractic Care and the ALCAT Procedure. Annals of Vertebral Subluxation Research, June 23, 2011, pp 44-50.

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Can Chiropractic Help With Asthma?

In the United States, asthma cases have increased significantly by about 60% in the past 30 years, with asthma related deaths now standing at 5,000 each year. With the rise in asthma cases, more patients are seeking alternative solutions to control their symptoms.

But is chiropractic care right for you? How effective is chiropractic care in diminishing your asthma symptoms? The answers will surprise you.

According to research, the skyrocketing number of asthma cases has to do with environmental variables such as increased pollution, food preservatives, mold and even genetics to name a few.

While seeing a young child with an inhaler was quite a strange site in the 1980’s, today it is not that uncommon to see several kids in a classroom take out their inhalers for much needed relief. Asthma has become a huge problem and everyone agrees that future generations can expect to see even higher numbers of sufferers. Unfortunately there is no cure for asthma but there are ways to control the symptoms and stop it from becoming a larger problem that it already is.

Experts agree that staying out of pollution, eating right, and living in a clean environment all help with the onset of symptoms, but what you may not have known is that chiropractic care has also been shown to reduce symptoms in both kids and adults alike. Why? Because another significant reason that contributes to the onset of asthma has to do with poor spinal health.

Sadly, today’s generation is glued to their smartphones, TVs, video games and computers, and spend very little time being active. Naturally, their postures suffer, causing slight to severe misalignments in their spine.

While most don’t realize the harmful effects of their poor posture, chiropractors know very well that even the slightest pressure on the delicate nerves can cause havoc elsewhere in the body, and not just manifest as pain, but issues with the function of vital organs.

Regular corrective chiropractic care has shown eliminate spinal misalignment, significantly increasing nerve flow energy and restoring the function of all critical organs, including the lungs, the heart and digestive systems.

CBP or Chiropractic BioPhysics is the most advanced, result-oriented chiropractic technique. Patients who have gone through the CBP treatment have shown significant improvements in their asthma. By addressing the root cause of the problem, CBP chiropractors are able to eliminate the major source of asthma and help patients live a more normal life again.

The majority of patients under the care of a CBP chiropractor not only report an immediate end to their asthma symptoms, but more importantly feel vibrant, energized, and notice their overall health improving every day.

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