Proceedings of the 1990 International Conference on Spinal Manipulation

Published by - Foundation for Chiropractic Education and Research

Softcover - 456 pages

On May 11-12, 1990 the International Conference on Spinal Manipulation was held at the Hyatt Regency Hotel in Washington, D.C. Presenting papers and attending the conference were some of the leading researchers in the field of biomechanics.

As with too many of us, wanting to go to a conference such as this and actually having the time or money to do so are sadly two different things. For months ads appeared in chiropractic publications extolling the virtues of the conference. It was almost painful for me to read knowing I wouldn't be able to be there.

To my surprise I was wrong, for in the mail came a publication of the proceedings for me to review. Texts like this give field doctors like you and I the opportunity to be in the front row of some of the most informative meetings our profession has to offer, without having to leave town or sacrifice valuable practice time. With a relatively small amount of money you can sit and take your time reading and learning from some of the finest researchers in the health field. For too many years we have lived in our philosophical ivory towers isolated, and often not of our own doing, from the rest of the scientific research community. The result has been a history of "research" structured along lines of self-gratification. In other words, "friendly" research biased to a predictable result.

To me, proper research should be an adversary to the concept postulated. It should attempt to disprove assumptions. In other words, the idea is fallacious until proven otherwise.

Clinically, we know that what we do works or we, as a profession, would have been out of business a long time ago. Instead we prosper and grow; but why?

While we need research to validate our existence, we must not let it become so powerful an entity that it paralyzes the clinician. Certainly medicine, with all its professional posturing, has never let research get in the way. They admit before congressional committees that they unfortunately can't prove the value of just about anything they do. This, however, has never stopped them from continuing to guess what is wrong with a patient and then trying to guess what dangerous chemicals to prescribe. At least what we do in the conservative healing arts carries a lighter therapeutic price tag.

The ICSM text is a splendid exercise into examination of theory. Divided into 17 sections, the volume contains some 84 papers that tease, excite, and disappoint.

Some reading this will undoubtedly approach it with very special convictions which might be challenged by what they read and this alone might cause you some questioning of these convictions. But then, this is what research is all about.

The first section deals with epidemiological and population studies and then progresses to such things as the need for x-rays and the referral patterns of California DCs. This, in turn, is followed by sections that address chiropractic field investigations; the efficacy of low back pain treatment; diagnostic imaging of the spine; the neurology and physiology of spinal manipulation; the cost-effectiveness of occupational health and treatment; cervical spine measurement and analysis; lumbar spine biomechanics; the assessment of spinal dysfunction and pain; the measurement of spine biomechanics; the development of standards of care in chiropractic; the clinical evaluation of spinal manipulation; examiner reliability in chiropractic procedures; more chiropractic field evaluations; and finally, the role of the chiropractic colleges in research.

Probably the most enjoyable section to me was the one on examiner reliability in chiropractic procedure. It brings both questions and the desire to know more.

Almost all the papers in the Proceedings Manual are short. This is an extra nice feature because you can pick up the text, open it to nearly any area, and learn a great deal. Believe me, this is one of the best volumes I've ever had the pleasure of studying. Its biggest problem is that it could spoil you for lesser efforts. You should purchase it and feel as proud as I do.

RHT