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Verb tense

This phrase still bugs me:

innate intelligence, "a vitalistic notion that brings ridicule from mainstream science and medicine."

I don't dispute its verifiability or accuracy, but it is using the active present tense, which is not typically used in encyclopedias. Recommend three options:

1. a vitalistic notion which has brought ridicule from mainstream science and medicine - present perfect tnese
2. a vitalistic notion that continues to bring ridicule from mainstream science and medicine. - present continuous
3. a vitalistic notion that "brings ridicule from mainstream science and medicine." - quotation

Thoughts? Ocaasi (talk) 21:59, 15 February 2011 (UTC)

I think all three are better than the current text, however, I dont know that the source supports the second proposal. If I had to choose one I would go with the first option.Puhlaa (talk) 22:07, 15 February 2011 (UTC)

The third one isn't actually an exact quote, and I think the exact quote is better:

• a vitalistic notion that "brings ridicule from the scientific and health care communities and confusion within the chiropractic profession."

So just the more informative, comprehensive and exact quote, and use quote marks. -- Brangifer (talk) 22:19, 15 February 2011 (UTC)

Agreed with BR's proposal, I like the exact quote for this.Puhlaa (talk) 22:28, 15 February 2011 (UTC)

Done. All this close paraphrasing without actual quotations makes for awkward reading. Think this is a good fix. Ocaasi (talk) 22:38, 15 February 2011 (UTC)

Some editors take paraphrasing too far. We are allowed to use exact quotes in moderation. Can we mark this section as resolved? If so, then would "the hunter who shot the deer" please do it? -- Brangifer (talk) 22:41, 15 February 2011 (UTC)

I did it. One question, though. I don't like direct quotations without attribution, but then you run into ASF issues, which is why I just prefer grammatical paraphrasing. So this one is settled half-way for me, but I'm ok with it for now. Ocaasi (talk) 22:49, 15 February 2011 (UTC)

Any direct quotation needs to be referenced, preferably with an inline citation as close to the quote as possible. But there's no need to attribute as well it unless you want to stress the point that it is the author's opinion. When the matter is undisputed among reliable sources, it's sufficient to allow the reader to check the reference if they are actually interested in the author of the quote. --RexxS (talk) 00:47, 16 February 2011 (UTC)

Agree on all points. Very legitimate concerns, but I agree with RexxS. This case shouldn't need attribution. Otherwise I generally think ASF is used far too much by QG and believe that "when in doubt, attribute". -- Brangifer (talk) 01:14, 16 February 2011 (UTC)

Are we dropping the Ernst review too soon?

Above objections have been expressed about this matter. Any thoughts or proposals about the matter? -- Brangifer (talk) 03:48, 16 February 2011 (UTC)

This issue was always why Ernst was included not the UK report. I don't recall suggesting that we take out Ernst just because it was older. That would not be how we handle two qualifying sources. Instead, we can try to summarize their collective findings, or if that is too contentious, just list the points of agreement and then attribute (as RexxS suggested) where they disagree, per 'Describe the dispute'. The strength of Misplaced Pages is that it is as comprehensive as it is up to date; Ernst is not a bad source here, just not the only source. Ocaasi (talk) 13:05, 16 February 2011 (UTC)

I maintain that Ernst can be removed from the LEAD in favour of new research. I am uncertain how a LEAD (a short summary of the body) benefits from something like including the older review regarding effectiveness. Would we write,

"A 2008 review suggested that manual therapies used by chiropractors are not good for anything (Ernst 2008). A 2010 review found that manual therapies used by chiropractors are effective for low back pain, neck pain, some headaches and some extremity joint condiditons (Bronfort 2010)".

The controversy around chiropractic is being too far extended here when we try to apply it to the evidence for the effectiveness, as without pseudoscientific ideas like innate and subluxation chiropractic is just another manual therapy. Some chiros troubling belief in these stupid ideas does not make their manual therapy any less effective. I wonder, if we go look at the physiotherapy article (physio's use the same types of therapies I believe - manips, mobs, rehab exercise, etc) does it say they are not effective for anything? Does the LEAD there go through the progression of the evidence for effectiveness or does it summarize the current state of the literature on effectiveness? As always, I am willing to conform to the majority view of reasonable editors, but the above is my opinion on the issue. Puhlaa (talk) 13:42, 16 February 2011 (UTC)

It's still possible for narrative reviews to come to different conclusions regarding manipulative efficacy. If Ernst and the UK report are both worth including in the body, then I think either both or neither are suitable for inclusion in the lead. To only use the UK report in the lead would be to take a clear stance that the more recent review is more accurate, which may or may not be true. At the least, we would have to use language such as the most recent systematic review of effectiveness.... But why can't we synthesize (the acceptable kind) the results of the studies into a coherent lead: Recent systematic reviews agree that a, b, c, are effective; are split over whether d, e, f, are effective, consistently find no benefit for g,h, and i, and need more data for j, k, and l. Or something like that. Ocaasi (talk) 14:47, 16 February 2011 (UTC)

If an adequate way of doing this is proposed then I will support it. Your current proposal will not work because Ernst says SM is not effective for anything "Collectively, systematic reviews of this research have not demonstrated that spinal manipulation is effective, with the possible exception of treatment of back pain." (Ernst 2008). This is inconsistent with the most recent review (UK report currently included), and with the info found in the body which incudes systematic reviews suggesting there may be effectiveness for low back pain (Spine Journal, 2010); neck pain (Manual Therapy, 2010); migrain (J Headache Pain, 2011); shoulder pain (JMPT 2010); leg pain (JMPT 2009); lumbar radiculopathy (Phys Med Rehabil Clin N Am, 2011). Why keep Ernst when it is clearly inconsistent with the current state of the literature and a review is available that IS consistent?

It is interesting that no editors are jumping on this idea with regard to the discussion of stroke in the lead. No one is questioning why systematic reviews that question the causational link between cervical manipulation and stroke are not included in the lead, only in the body. Why is there such inconsistency? Only Ernst most recent 2010 review needs to be included with regard to stroke, but older reviews must be included with regard to efficacy? I aacknowledge that you have brought up this issue Ocaasi, but you are the only editor who has)Puhlaa (talk) 15:12, 16 February 2011 (UTC)

Puhlaa, you know my stance on the stroke situation. Namely, I think we are grossly under-representing its complexity in the lead as well. That is something I would like to fix. But mentioning Ernst was not only my idea. See the WikiProject Medicine thread, where RexxS and others emphasized the need to include Ernst as well. Ocaasi (talk) 15:36, 16 February 2011 (UTC)

Like I said, I wont revert if Ernst is included based on majority agreement, I just contend that it is inconsistent with how policy is applied in other articles and in other sections of this article. I will shut up now :) I gave my opinion...I will wait for the changes to be made (Ernst re-included) or others to weigh in :) Puhlaa (talk) 15:38, 16 February 2011 (UTC)

If it's any help, WP:LEAD recommends that only notable disputes need to be included in the lead. I'm really not qualified to make that judgement myself, but perhaps someone is aware of a source that examines the extent of the disagreement between the two views expressed? Anyway, I'd expect that the body of the text ought to at least mention that reliable sources are not unanimous on the effectiveness of chiropractic methods. If pressed, I'd suggest the body contained something along the lines of:

• "A 2010 systematic review concluded that manual therapies used by chiropractors are effective for the treatment of low back pain, neck pain, some forms of headache and some extremity joint conditions, although a 2008 critical evaluation only found evidence for the effectiveness of SM in treating back pain."

which is about as dispassionate as I can write it. Others may be able to do better. The lead at present says:

• "Many studies of treatments used by chiropractors have been conducted, with conflicting results. Collectively, research has suggested that manual therapies commonly used by chiropractors are only effective for the treatment of low back pain, neck pain, some forms of headache and some extremity joint conditions."

and I guess that is a fair overview of what we know. Does anyone want to see much more detail than that? I'd only suggest changing the last phrase to "some joint conditions in the extremities" as the current wording reads awkwardly to me. Hope that helps. --RexxS (talk) 16:51, 16 February 2011 (UTC)

I'm okay with both of those. I get a little tripped up on the word 'only', but it can wait. Ocaasi (talk) 17:47, 16 February 2011 (UTC)

I see there never was consensus to drop the Ernst review. Editors should report what the source says rather than deleting a MEDRS compliant source. QuackGuru (talk) 20:45, 6 March 2011 (UTC)

Chiropractic treatment prompts shingles

I recall reading that chiropractic treatment can cause the varicella zoster virus to break out from its latent position in nerve cell bodies in the spinal nerve, where the chiropractic-released virus causes shingles. Mechanically speaking, this makes sense. The article probably should touch on this. -- Uzma Gamal (talk) 14:49, 23 February 2011 (UTC)

Do you have a source for that? -- Brangifer (talk) 18:26, 4 March 2011 (UTC)

Osteopathy

Why no mention of the obvious and, to the public, very similat therapy Osteopathy? — Preceding unsigned comment added by 207.245.198.135 (talk • contribs) 2011-02-22, 17:15 (UTC)

There currently exists in the article the sentence: "Chiropractic overlaps with several other manual-therapy professions, including massage therapy, osteopathy, physical therapy, and sports medicine." Further, in the LEAD, chiropractic is described as: "The main chiropractic treatment technique involves manual therapy, including ...". The description of manual therapy implies the similarity with other manual therapy professions, and the linked article on manual therapy further makes this comparison. There may be room for expansion of the sentence in the LEAD to explicitly state the similarity to other manual therapies, but I dont know that this is necessary.Puhlaa (talk) 20:13, 24 February 2011 (UTC)

Recent edit says Disorders = subluxations

Lets not use wikipedia to push what WE think "defines" chiropractic! The World Federtaion of Chiropractic (WFC) is made up of the national associations of chiropractors in 85 countries. The WFC represents them and the chiropractic profession in the international community. The WFC defines chiropractic as:

"A health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation."

My two cents: While "subluxation" was traditionally a term used by chiropractors to describe the spinal dysfunctions they treat, it is not consistent with "current chiropractic", nor is it what "defines" the profession. After 3 years in chiropractic college I have not heard subluxation once with regard to diagnosis or treatment! The only time I have heard the term used is in chiropractic history class. The same can be said by my colleagues at NYCC, NUHS, WSCC, etc. There are few schools still instructing the use of this term as it is inconsistent with its greater usage in "conventional medicine" and causes confusion. Besides, if chiropractic were to be defined by any single thing, it would be spinal manipulation. — Preceding unsigned comment added by Puhlaa (talk • contribs) 23:18, 3 March 2011 (UTC)

Puhlaa, I can agree with your last sentence, and that should actually be added (let's remember to do it), but otherwise your school and the scientific reform, anti-vertebral subluxation position is still a minority position, so much so that the National Association for Chiropractic Medicine actually gave up their reform efforts and closed shop. Reform has been well-nigh impossible to push through. As a science based chiro student you know this and I'm surprised. I suspect you only surround yourself with other likeminded chiros and are oblivious to what's still going on in the rest of the profession. The ICA and WCA are still very much alive and active, but the NACM is gone. The subluxationists have won.

Most (all!) middle aged and older practicing chiropractors were educated under the subluxation paradigm and will not allow a non-subluxation based new chiro to work for them, and most new graduates are still from straight schools, at least in the USA, which produces most chiros.

I don't know what the situation is in Canada, but in the USA chiropractic is legally defined by the vertebral subluxation and only subluxation treatment is reimbursed, which puts the profession in a real dilemma. If they don't treat subluxations, Medicare won't pay. It's the legal and philosophical foundation of the profession, so even those modern chiros who would like to change things can't do it. That would break the law that defines the profession.

You lead out with an ironic accusation: "Lets not use wikipedia to push what WE think "defines" chiropractic!" Not only would WP:Kettle apply, but I'd say it's the other way around. You're trying to force the article to describe the profession the way you WISH it were, but you're wrong. (Another Canadian chiro...who is banned... tried to do the same thing.) The profession is much more than Canada. Again, I sympathize with your plight, but that's life. The profession isn't out of the forest of pseudoscience quite yet. There are clearings in the forest that enclose pockets of scientific fresh air, and you operate in one, but that's not the whole forest. The rest of the forest is still filled with plenty of dank, damp, rotting pseudoscience fumes. Too many chiros are educated in subluxationism, and they won't give up, and USA Medicare and state laws prevent even those who'd like to change things from doing so. It's written in black and white in the laws defining what chiropractors are allowed to do, and what they are required to do, each and every treatment. This situation was all created so that chiropractors couldn't get prosecuted for practicing medicine without a license, and so they could get reimbursed.

In the UK the GCC recently dissed the subluxation, but the BCA has fought back and the GCC has backed down and modified their position, so subluxationism is still alive and well in the UK, just as it is in the USA. Reform is being resisted by the rank and file. Too bad.

BTW, you've worded the heading misleadingly. That was in my edit summary. Otherwise, to sum this up, the article isn't about what we might wish chiropractic were (we both wish it would drop the old VSC nonsense), it's about what it is, both new and old, good and bad. My edit made it clear what the reality is. I'm willing to tweak it if you have some suggestions for improvement, but wholesale reverting isn't called for since my edit made the initial introductory sentences more accurate. As it was it described my profession of Physical Therapy (!), without mentioning what was unique to chiropractic. That came too far down in the lead, and I fixed that. Readers should know immediately what makes chiropractic unique and special. It shouldn't be buried way down there because some science based chiropractic editors are embarrassed by the fact. That's POV editing and that's not allowed here. This isn't a brochure describing some ideal image according to a newer and future paradigm that is only in place in a few spots.

Now, let's look at that edit in the subsection below and see if it can be improved. -- Brangifer (talk) 08:33, 4 March 2011 (UTC)

Tweaking the first sentence of the lead

First tweak by Brangifer

I made an edit (underlined below) which got reverted:

• "Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especiallyprimarily through treatment of vertebral subluxations of the spine, under the hypothesis that these disorderssubluxations affect general health via the nervous system."

What is wrong with that? Before it was the definition of Physical Therapy. Now it describes chiropractic as it is in most places, and as it is legally required to be in the USA.

Let's also remember to incorporate the idea in your good comment above:

"if chiropractic were to be defined by any single thing, it would be spinal manipulation."

That too is true, but what is being adjusted is the vertebral subluxation: "manual manipulation of the spine to correct a subluxation". That's by law in the USA. Both words are present:

• "The Social Security Act limits Medicare coverage for chiropractic services to "treatment by means of manual manipulation of the spine to correct a subluxation demonstrated by x-ray to exist." Because chiropractic theory regarding illness differed so greatly from mainstream medicine, the x-ray requirement was written into the benefit as an attempt to "control program costs by insuring that a subluxation actually exists." The consensus, from the chiropractic community as well as representatives of the health care field, is that the x-ray requirement has not served this purpose."

In 2000 the x-ray requirement was dropped, but the wording is still the same. Note that it must be "manual". All the instrument adjusting is actually not billable, but in practice it is billed and paid. To bill Medicare for a treatment, IF the chiropractor carefully follows the law, the treatment session must include a "manual" manipulation of the "spine", using a "subluxation" diagnosis, regardless of what's wrong with the patient. American law requires chiros to practice straight chiropractic. That's a far cry from what you've been doing at CMCC, but CMCC graduates are still practicing subluxation-based chiropractic all over the world. Even if the new ones weren't trained that way, they can rarely get an internship where they are not required to begin practicing this way, and they quickly get turned into subluxation-based chiros to survive.

THAT'S the reality which this article must describe. If we followed policy here and included the contents of the Chiropractic controversy and criticism article in this main article, it would be more evident what the reality of the situation really is, but the subject matter in that article can only exist at Misplaced Pages because it is hidden away from the public "over there". That's because of some very obstinate subluxation-based (and then a banned anti subluxation-based) editors we've had here who controlled this article. Each for very different motives chose the same solution - hide the embarrassing facts. -- Brangifer (talk) 08:44, 4 March 2011 (UTC)

Second tweak by Ocaasi

Why don't we emphasize the complexity, tradition, and variance in the definition. As an encyclopedia, we shouldn't "pick" which definition is accurate; we should take seriously that we can summarize the dispute among sources. For example:

Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, traditionally through management of vertebral subluxations--misalignments of the spine--under the hypothesis that they affect general health via the nervous system. The most common method of treatment is direct spinal manipulation, although chiropractors also..."

Whatcha think? Ocaasi (talk) 18:13, 4 March 2011 (UTC)

Bingo! That's PRECISELY the direction we should be going, and which policy requires. While using definitions from RS isn't forbidden and is often a good thing, a Misplaced Pages lead as a whole summarizes the whole article, and the first sentence(s) should provide a definitional description, but still based on the whole article, not some external quote of an existing definition not based on our NPOV/covering-all-significant-POV article content. That's why Misplaced Pages definitions end up being better than definitions from any other source. Those definitions are usually founded in a specific promotional agenda, and the WFC definition is such a definition. It's a promotional, wishful thinking, marketing tool.

Your suggestion is very good. Let's work on it as it has great potential. -- Brangifer (talk) 19:01, 4 March 2011 (UTC)

My first tweak would be to leave out the explanation of VS, as that describes a real, orthopedic "subluxation", not the chiropractic VS, which is a fictional entity unlike the mainstream definition of "subluxation", although the chiropractic VS includes real subluxations. Even the WHO notes the difference. By using those words, we're actually making it sound like chiropractors are always treating real subluxations, when that is rarely the case, and when sensible chiropractors encounter them, they will often send the patient directly to the emergency room. We should also link to spinal adjustment, not to manipulation, since that's what makes chiropractic unique. The difference isn't physical, but philosophical. -- Brangifer (talk) 19:01, 4 March 2011 (UTC)

My second idea would be to add to or modify the "mechanical disorders of the musculoskeletal system" wording, since the reason for manipulating the spine is either for treating back pain, or, when performed by straight chiropractors, for treating ALL diseases in the body, not just the musculoskeletal system. They are interested in treating the whole body, which they believe can be done by tweaking the spine.

We just need to make sure the description includes all facets of chiropractic as practiced today, both the minority, more science-based kind, and the majority straight kind. Regardless of the fact that a number of chiropractic schools are phasing out the use of the word "subluxation", they are still teaching the same form of treatment, but using other words, and pretty much all the existing middle aged and older chiropractors are actually subluxation-based and force even their science-based interns to practice that way, thus undoing their education. That's reality, and we must describe it, not some future ideal as envisioned by modern reform chiros and critics of chiropractic. -- Brangifer (talk) 19:01, 4 March 2011 (UTC)

Third tweak by Brangifer

Here's a tweak of Ocaasi's version:

Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, traditionally through management spinal adjustment of vertebral subluxations--misalignments of the spine--under the hypothesis that they affect general health via the nervous system. Straight chiropractors use spinal adjustments to treat all diseases, including visceral conditions. The most common method of treatment is direct spinal adjustment, although Chiropractors also use other methods..."

How about that? Please suggest tweaks. -- Brangifer (talk) 19:16, 4 March 2011 (UTC)

Fourth tweak by Ocaasi

• I like getting rid of 'management' which was a weak word. "Spinal adjustment" is probably a tad redundant, since we're talking about subuluxations--I think just 'adjustment' would suffice.
• I think we should define subluxation in the lead. You might take issue with 'misalignments' since it suggests they exist but I think we need a simple explanation... Maybe 'theorized misalignments' or something...
• Hesitant to use the term Straight until we've given an overview of the field and differences among practitioners.
• I'd like Puhlaa's input for rounding out the not-traditionally side of things, since we give an indication that treating subluxations certainly used to be the primary method, and may still be, but haven't filled in the holes about what alternative treatments there are, and how prominent they have become. Ocaasi (talk) 19:34, 4 March 2011 (UTC) So my best so far would be:

Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, traditionally through adjustment of vertebral subluxations--theorized misalignments of the spine--under the hypothesis that they affect general health via the nervous system. The most common method of treatment is direct spinal adjustment, exclusively so for classically trained or Straight chiropractors who adhere to the subluxation model as the cause of all disease. Non-Straight Chiropractors, or Mixers, also use other methods including . Something about modern, scientifically based practices...

Just throwing some out there. Ocaasi (talk) 19:46, 4 March 2011 (UTC)

Excellent! This is getting to be quite good. -- Brangifer (talk) 01:12, 5 March 2011 (UTC)

A couple points. First, although there may still be a few dogmatic nuts around, most chiropractors do not believe that subluxation is a misalaignment of the vertebrae. This was one of Palmers original therories, and was tossed out along time ago. I would encourage you to read this short paper on the evolution of the chiropractic subluxation by Howard Vernon . Thus, including this statement in the definition is troublesome, it belongs in the history of subluxation section in the body. Second, your definition uses traditional and straight, one should be used consistently. I prefer traditional, as the straight/mixer thing is becoming obsolete because only one school in the world teaches true straight chiropractic anymore - Sherman - hands only, spine only. It has become more of a traditional/dogmatic group vs a modern/evidence-based group. Third, there is a mistake in your definition of traditional/straight chiropractors as they dont believe subluxation causes all disease, they believe it causes dis-ease (lack of ease or improper body function). They believe only a body not functioning properly (dis-eased) gets disease. It is confusing, but very few chiros will say they can cure disease, they cure dis-ease and the body then cures the disease (clear as mud?). I even agree with this to a small extent, as a person not functioning optimal (weak immune system, no sleep, in pain, etc.) will get sick easier than someone who is functioning optimally. Modern chiros just dont agree that spinal manipulation is the #1 way to prevent dis-ease to prevent disease :) PS. why is there a seperate article for adjustment and spinal manipulation? This is ridiculous! They should be merged, or spinal adjustment article just deleted. Adjustment is spinal manipulation, just with some dogma thrown in the mix. Was this done by a traditional chiro trying to emphasize the dogma in his practice?

Lastly (for now), It seems that your new definition contains all the info that already exists in the first paragraph of the LEAD, just in a diferent order? If you are just wanting to emphasize the pseudoscience (which is what it appears), then just move the last sentence of the fist paragraph from the article "Traditional chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function and its innate intelligence, a vitalistic notion that "brings ridicule from the scientific and health care communities and confusion within the chiropractic profession."" And place it as the second sentence instead. Thus, the opening paragraph would be:

• Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system. Traditional chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function and its innate intelligence, a vitalistic notion that "brings ridicule from the scientific and health care communities and confusion within the chiropractic profession." Chiropractic is generally categorized as complementary and alternative medicine (CAM), a characterization that many chiropractors reject. Although chiropractors have many attributes of primary care providers, chiropractic has more of the attributes of a medical specialty like dentistry or podiatry. The main chiropractic treatment technique involves manual therapy, including manipulation of the spine, other joints, and soft tissues; treatment also includes exercises and health and lifestyle counseling.

Puhlaa (talk) 19:00, 5 March 2011 (UTC)

Objections by Puhlaa

Sorry to be a stick-in-the-mud, but at the moment I am still somewhat disappointed that two veteran editors would be trying to synthesize (WP:OR?) a new definition of chiropractic to open the LEAD when there is already a definition in the LEAD that meets WP:V. BR, you accuse me of WP:kettle for saying that the current LEAD (that meets WP:V) should remain instead of your WP:OR definition? Please explain? Have you both sat back and thought about if it is consistent with wikipedia policy to synthesize a new definition of chiropractic just so that you can include a couple dogmatic words that YOU think defines the profession? A good explanation for what you are doing is NOT because the LEAD must summarize the body, as subluxations have already been introduced in the LEAD ("For most of its existence it has battled with mainstream medicine, sustained by pseudoscientific ideas such as subluxation and innate intelligence").

IMO, If you are not happy with the current definition found in the LEAD, then an alternate definition that meets WP:V and pleases all editors should be used rather than a critic and a layperson trying to synthesize a new definition that suits their view of the profession. BR, if you are not happy with the current definition in the LEAD (which is from the world federation of chiropractic, a body that represents 85 national chiropractic associations including the ACA and the CCA), perhaps one of the following established definitions that meets WP:OR will work:

• Medicare : "Chiropractic Medicine - employs manipulation and adjustment of specific areas of the body (often of the spine) to prevent and treat disease and nerve function."
• The National Center for CAM (NCCAM) : "Chiropractic is a health care profession that focuses on the relationship between the body's structure—mainly the spine—and its functioning. Although practitioners may use a variety of treatment approaches, they primarily perform adjustments (manipulations) to the spine or other parts of the body with the goal of correcting alignment problems, alleviating pain, improving function, and supporting the body's natural ability to heal itself."
• The Association of Chiropractic Colleges : "Chiropractic focuses on the relationship between the body's main structures – the skeleton, the muscles and the nerves – and the patient's health. Chiropractors believe that health can be improved and preserved by making adjustments to these structures, particularly to the spinal column. They do not prescribe drugs or perform surgical procedures, although they do refer patients for these services if they are medically indicated."

If you are insistent on including the word subluxation because for some reason you think this "defines" chiropractic, then what about the definition from

• The World Health Organization: "A health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation with a particular focus on subluxations."

If none of these, then somone is going to have to explain to me why a newly synthesized definition is better than an established definition by one of the above well established bodies. Please include in the explanation how this meets wikipedia policy. If that happens (as I might be completely wrong about all this) then I will assist in producing a brand new definition of chiropractic with the two of you that includes the words that YOU say define chiropractic. Puhlaa (talk) 00:46, 5 March 2011 (UTC)

Two quick points. One, I'm not that veteran, though I take your concern seriously.

Two, we're not trying to "write" a definition whole-cloth, but to synthesize a definition (a bad word, but only OR if it's not back-up-able by sources) considering that there are some differences of emphasis or outright approach among Chiropractic organizations and practitioners. The reason I am inclined to this approach is that definitions are concrete things but which one do you pick? So we write 'our own' but it's more a nod to summary than synthesis, I believe. Some editors have less tolerance for this kind of thing and see it as clearly outside of policy (and certainly OR misuses can happen under the flag of 'summary'); meanwhile, BR and I, along with some other editors feel that we are in a unique position to necessarily and even optimally summarize competing, subtly varying, or just differently worded approaches. Therein lies a difference of approach, but as long as it comes out with a definition that all parties reasonably agree on, and which covers major aspects presented in most sources, in a way which is accessible to the reader... I personally don't care where we got it.

So let's get to the issue--what is wrong with the proposed drafts? How would you 'define' the field properly, to take into account both the breadth, tradition, complexity, deviations, and change?

A quick note, I thought 'traditionally' made the reference to subluxation much less 'dogmatic'. I have no problem with a variety of approaches here, as long as we cover all of the bases, one of which--and not a trivial one at that--is the Straight/historical side of subluxation. However we present that is ok with me, and maybe it doesn't belong in the first sentence... but the second or third? Ocaasi (talk) 01:00, 5 March 2011 (UTC)

Puhlaa, you're definitely not a stick-in-the-mud! Your input is valued and we were waiting for it. I think we can hammer this out together into a consensus version. There is no rush.

The first thing to do is make it clear that we're doing what is required at Misplaced Pages, and it's not OR. We are summarizing the article, but summarizing the parts (which are indeed sourced) which can be used to make a definition/description that is based on the article contents, not an unbalanced or promotional definition from somewhere else. Like I said above, it's not wrong to use such definitions as content, but if they aren't based on our article's contents, we need to make our own Misplaced Pages definition/description which more accurately describes the profession. Our definition must also be an accurate description of all of chiropractic, not just of a part or future ideal. Go back above and read what I and Ocaasi have written as our justifications for doing this. Such summarization isn't even close to OR since it's based on sourced content. No new ideas are created in the process.

This doesn't prevent us from ALSO creating a section for various definitions, and that might be informative to readers and show how they vary. I wouldn't be averse to doing that at all. The danger of POV editing in that process is very real, because who's to decide which definitions to use? Cherry picking definitions is touchy business(!), but together we could probably agree on a handful to use. We just need to deal with the fact that definitions and descriptions from other sources don't do the subject justice since they are often conflicting, only written from one POV, or are promotional in nature, such as the WFC definition. That definition is so broad that it actually defines Physical Therapy(!), ignoring many aspects of the subject and actual practice. The part that is uniquely chiropractic comes too far down in the lead. -- Brangifer (talk) 01:48, 5 March 2011 (UTC)

The ACC paradigm definition of the profession and of VS is important to note here:

• "Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation. A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health. A subluxation is evaluated, diagnosed, and managed through the use of chiropractic procedures based on the best available rational and empirical evidence." - "Technique systems in chiropractic"

Brangifer (talk) 02:01, 5 March 2011 (UTC)

Also, in keeping with Puhlaa's good point about the primacy of the adjustment, here's another good one:

• "SPINAL MANIPULATION: THE CORE CHIROPRACTIC ACT
  Adjusting with the hands—the signature chiropractic gesture—is the unifying activity that allows chiropractic to transcend its internal discord and create a coherent profession. Overriding disputes within the profession, the core question for all chiropractors remains unchanged and agreed on: how should the hands move the vertebrae? Beneath doctrinal disparity and clinical diversity, chiropractic has an internal cohesion that is more than a defensive reaction to a critical world. Chiropractors believe that the correction of spinal abnormality—the adjustment of vertebrae—is a critical healing act."

Brangifer (talk) 03:44, 5 March 2011 (UTC)

Edit request from Mg87DC, 7 March 2011

It is requested that an edit be made to the semi-protected article at Chiropractic. (edit · history · last · links · protection log) This template must be followed by a complete and specific description of the request, that is, specify what text should be removed and a verbatim copy of the text that should replace it. "Please change X" is not acceptable and will be rejected; the request must be of the form "please change X to Y". The edit may be made by any autoconfirmed user. Remember to change the |answered=no parameter to "yes" when the request has been accepted, rejected or on hold awaiting user input. This is so that inactive or completed requests don't needlessly fill up the edit requests category. You may also wish to use the {{ESp}} template in the response. To request that a page be protected or unprotected, make a protection request.

I would like to have the following added to the "Cost-effectiveness" section of this wiki page.

A 2010 research article found that beneficiaries had a 40% lower overall cost for treatment of low back pain when they initiated care with a DC than those who initiated care with an MD.

my cited source is as follows.

Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer Richard L. Liliedahl, Michael D. Finch, David V. Axene, Christine M. Goertz Journal of Manipulative and Physiological Therapeutics_dev November 2010 (Vol. 33, Issue 9, Pages 640-643)

http://www.jmptonline.org/article/S0161-4754%2810%2900216-2/abstract Mg87DC (talk) 22:34, 7 March 2011 (UTC)

The source is not reliable. See WP:MEDRS. QuackGuru (talk) 18:16, 8 March 2011 (UTC)

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