Dear All
There are two reoccuring themes which present on the list when dealing
treatments and efficacy.
1 The Drive of EBM is good but we must not think it is all encompassing.
When we have excellent research evidence we must use it. If we do not have
it, we should strive to produce it. In its absence use our clinical
experience/common sense, a much under appreciated resource.
2 Techniques work clinically but perhaps not for the reasons we believe, a
mislabelling problem. Herb Silver addressed this point well in his last
posting.
To a degree non clinicians may have to trust clinicians where the above grey
areas exist in scientific knowledge. They must believe in moral/ethical and
professional terms that the clinician is using ALL, resources available to
them to get the patient better. It is in no ones professional interest not
to get patients better. There is no panacea in musculoskeletal medicine, all
modalities have there successes and failures. The challenge to the clinician
is to keep the learning impetus and refine clinical reasoning to use the
most likely modality/cocktail of modalities, which will improve the patients
suffering.
Hope this is not too rambly.
Warm Regards Kevin Reese PT UK
----- Original Message -----
From: Mike Barthmann <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, January 21, 2001 12:18 AM
Subject: Re: Cranio-Sacral Therapy
> "Douglas M. White" wrote:
>
> > Mike:
> >
> > Have you read the studies I cited? If so, what do you make of them?
> >
> > *******************************************************
> >
> > Douglas M. White, PT, OCS
> > Physical Therapist, Consultant
> > 191 Blue Hills Parkway
> > Milton, MA USA 02186
> > P: 617.696.1974
> > [log in to unmask]
> > http://DouglasWhite.tripod.com
>
> Hi Doug,
>
> Yes, I did read at least one of the JOSPT articles. They were written as
I
> recall by people in the military who had taken some of the Upledger
courses.
> As I recall, the thrust of the pieces was that they used Cranial
Technique in
> their own practice but bemoaned the fact that there was little research to
> back up the science behind the concept.
>
> To address that particular issue I guess I would have to agree - there is
a
> dearth of good research to back it all up. That is in turn a shame
because it
> is an enormously powerful treatment modality that finds usefulness in the
> management of many somatic complaints including spinal dysfunction and
> headache complaint. Cranial suffers from the same difficulty that many
> physiotherapy treatment approaches do - namely there's no product or
company
> that is likely to benefit from enquiry into this area - so nothing gets
> done...
>
> There was an excellent URL on the net until about two years ago as part of
the
> rhemamed site that carried back issues of "The Cranial Letter" which
speaks
> much more eloquently than I ever will. Sadly, that site is now down. The
> hard copy of the Cranial Letter is still available from the Cranial
Academy
> whose address is as follows:
>
> The Cranial Academy
> 3500 DePauw Blvd Ste 1080
> Indianapolis IN
> 46268-1136
> 317-879-0713
>
> The intent of my post I suppose is to stand in defense of the integrity of
> Cranial Technique - it's not some airy-fairy fly-by-night fad. It won't
go
> away - there is underlying truth to the concept. People will continue to
> notice its effectiveness and in good conscience will not want to deny
their
> patients access to the help it affords.
>
> My own background is not at all research based so I feel a sense of
> frustration that I can't just thump down the proof on the table and say
here -
> read that. Take it on an article of faith that this is an area of
fruitful
> study and consideration for learned people. I use Cranial Technique in my
own
> manual therapy practice and can attest to usefulness and effectiveness of
this
> therapeutic modality.
>
> Kind regards,
>
> Mike Barthmann
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