Talk:Physical therapy

The chiropractic and spinal manipulation part

Howard, you've got some good work and insight in the section on chiropractic and spinal manipulation and the controversy there, but being the front article for Physical therapy, do you think we need to even mention chiropractic or get into the whole spinal manipulation issue? It begs to question that we discuss all the issues with the various forms of exercise (passive, active, eccentric, etc.) with the pros and cons and who does which and what as well. However, an article on Spinal manipulation could certainly make the distinction between manipulation, mobilization, and adjustment... This article probably should be for describing Physical Therapy and what they do, which does include spinal manipulation, and what they do not do, which is prescribe medication.

As an aside, the things that Chiropractic and Physical Therapists do are similar and there is a lot of overlap, especially as the science is now being persued to give us an idea of what works and what doesn't for which conditions. I don't think anyone argues that spinal manipulation is beneficial anymore; the argument is "for what?" It's just as beneficial for PTs as it is for Chiros. However, if you are performing manipulation to reduce adhesions, that's one thing, but if you are using it to create an autonomic response to affect the brain and nervous system and affect health, that's another. Obviously, whether you are a PT or Chiro, you are both going to have the same effect no matter what your objective. The other distinction is certainly the autonomous vs allied arrangement from a historical/political perspective. The question is which direction each profession is heading, both in opposite directions toward each other.. impact is inevitable. D. Matt Innis 21:55, 1 June 2010 (UTC)

Spinal manipulation indeed may be a very good idea, with some of the details here moving there. I do think, however, that something of the historical/political belongs here, and, indeed, perhaps in chiropractic. One DC/PT I saw thought the professions might someday merge, but he was thinking of effect: "PT is best for strength and chiropractic for flexibility." This may be the thinking, however, of very few people.

I can't help but think, however, that either in cost control or in integrative medicine, the overlap will be increasingly visible. One issue mentioned by some of the PT's was that they don't use X-rays so the patient isn't exposed to radiation -- but if it is needed for diagnosis, who does it? The radiation argument is a very intense one in medicine, especially with the statistically demonstrable (but low) increased cancer risk of some of the CT techniques. It's a constant battle on one of my trauma surgery mailing lists if too much imaging, or the wrong kind of imaging, is being used. Howard C. Berkowitz 23:08, 1 June 2010 (UTC)